Incidence Rate of Acute Encephalitis Syndrome without Specific Treatment in India and Nepal

PubMed Central

Potharaju, Nagabhushana Rao

2012-01-01

Background: A performance target (PT) for the incidence rate (IR) of acute encephalitis syndrome (AES) was not defined by the World Health Organization (WHO) due to lack of data. There is no specific treatment for ~90% of the AES cases. Objectives: (1) To determine the IR of AES not having specific treatment (AESn) in two countries, India and Nepal. (2) To suggest the PT. Subjects and Methods: This was a record-based study of the entire population of India and Nepal from 1978 to 2011. The WHO definition was used for inclusion of cases. Cases that had specific treatment were excluded. IR was calculated per 100,000 population per annum. Forecast IR was generated from 2010 to 2013 using time-series analysis. Results: There were 165,461 cases from 1978 to 2011, of which 125,030 cases were from India and 40,431 were from Nepal. The mean IR of India was 0.42 (s 0.24) and that of Nepal was 5.23 (σ 3.03). IRs of 2010 and 2011 of India and that of 2011 of Nepal were closer to the mean IR rather than the forecast IR. IR of 2010 of Nepal was closer to the forecast IR. The forecast IR for India for 2012 was 0.49 (0.19-1.06), for 2013 was 0.42 (0.15-0.97) and for Nepal for both 2012 and 2013 was 5.62 (1.53-15.05). Conclusions: IRs were considerably different for India and Nepal. Using the current mean IR as PT for the next year was simple and practical. Using forecasting was complex and, less frequently, useful. PMID:23293439

From Yashwant Place to Yashka: A Case Study of Commodification of Russian in India

ERIC Educational Resources Information Center

Suryanarayan, Neelakshi

2017-01-01

The present paper is a case study of how the commodification of the Russian language has transformed a market in New Delhi, India, inaugurated in 1969 and known as Yashwant Place. Over the years, the market slowly assumed a new identity, referred to as Yashka not only by Russian visitors but also tourists from countries of the former Soviet Union,…

Exploring Situational Factors Shaping Access in a Laptop Program for Socially Disadvantaged Children in India: A Case Study

ERIC Educational Resources Information Center

Padmanabhan, Poornima; Wise, Alyssa Friend

2012-01-01

Low-cost laptop programs attempt to address gaps in access to computers in developing countries. However, the translation of computing access from intention to actuality is mediated by many situational factors. This research presents a case study of how access to a set of laptops donated to a school for socially disadvantaged children in India was…

Genetic variations in the Dravidian population of South West coast of India: Implications in designing case-control studies.

PubMed

D'Cunha, Anitha; Pandit, Lekha; Malli, Chaithra

2017-06-01

Indian data have been largely missing from genome-wide databases that provide information on genetic variations in different populations. This hinders association studies for complex disorders in India. This study was aimed to determine whether the complex genetic structure and endogamy among Indians could potentially influence the design of case-control studies for autoimmune disorders in the south Indian population. A total of 12 single nucleotide variations (SNVs) related to genes associated with autoimmune disorders were genotyped in 370 healthy individuals belonging to six different caste groups in southern India. Allele frequencies were estimated; genetic divergence and phylogenetic relationship within the various caste groups and other HapMap populations were ascertained. Allele frequencies for all genotyped SNVs did not vary significantly among the different groups studied. Wright's FSTwas 0.001 per cent among study population and 0.38 per cent when compared with Gujarati in Houston (GIH) population on HapMap data. The analysis of molecular variance results showed a 97 per cent variation attributable to differences within the study population and <1 per cent variation due to differences between castes. Phylogenetic analysis showed a separation of Dravidian population from other HapMap populations and particularly from GIH population. Despite the complex genetic origins of the Indian population, our study indicated a low level of genetic differentiation among Dravidian language-speaking people of south India. Case-control studies of association among Dravidians of south India may not require stratification based on language and caste.

Strategies for waste management in small and medium towns of developing countries: a case study of India.

PubMed

Sundaravadivel, M; Vigneswaran, S

2003-01-01

This paper evaluates the issues of waste management in small and medium towns (SMTs) (with population in the range of 10,000-100,000) of India, and identifies the need for a multi-disciplinary approach encompassing technological, economic and financial aspects of the issues to effect improvements. A comprehensive set of cross-disciplinary strategies is suggested to improve the prevailing conditions with environmentally appropriate, economically efficient and financially self-sustaining waste management services. Based on a case study of four SMTs in the State of Tamil Nadu in India, this paper evaluates the application of the suggested strategies and offers policy recommendations.

The Development of Technical and Vocational Education in India--A Case Study in Quality Improvement. Case Studies on Technical and Vocational Education in Asia and the Pacific.

ERIC Educational Resources Information Center

Mishra, Arun K.

Education has a place of high priority on India's development agenda. The technical/vocational education (TVE) system is multisectoral with each ministry responsible for labor force development in that sector. The TVE programs in the formal education system are either state delivered or financed. The higher secondary vocational education program…

World Perspective Case Descriptions on Educational Programs for Adults: India.

ERIC Educational Resources Information Center

Jayagopal, R.; Burns, E. P.

Four adult education programs being conducted in India are described in the case studies in this packet. Two of the projects involve literacy; the third promotes literacy as one part of its community development program, and the fourth trains workers in hotel management and catering technology. The literacy programs are (1) development of a…

Identification of burden hotspots and risk factors for cholera in India: An observational study

PubMed Central

Sen Gupta, Sanjukta; Arora, Nisha; Khasnobis, Pradeep; Venkatesh, Srinivas; Sur, Dipika; Nair, Gopinath B.; Sack, David A.; Ganguly, Nirmal K.

2017-01-01

Background Even though cholera has existed for centuries and many parts of the country have sporadic, endemic and epidemic cholera, it is still an under-recognized health problem in India. A Cholera Expert Group in the country was established to gather evidence and to prepare a road map for control of cholera in India. This paper identifies cholera burden hotspots and factors associated with an increased risk of the disease. Methodology/Principle findings We acquired district level data on cholera case reports of 2010–2015 from the Integrated Disease Surveillance Program. Socioeconomic characteristics and coverage of water and sanitation was obtained from the 2011 census. Spatial analysis was performed to identify cholera hotspots, and a zero-inflated Poisson regression was employed to identify the factors associated with cholera and predicted case count in the district. 27,615 cholera cases were reported during the 6-year period. Twenty-four of 36 states of India reported cholera during these years, and 13 states were classified as endemic. Of 641 districts, 78 districts in 15 states were identified as “hotspots” based on the reported cases. On the other hand, 111 districts in nine states were identified as “hotspots” from model-based predicted number of cases. The risk for cholera in a district was negatively associated with the coverage of literate persons, households using treated water source and owning mobile telephone, and positively associated with the coverage of poor sanitation and drainage conditions and urbanization level in the district. Conclusions/Significance The study reaffirms that cholera continues to occur throughout a large part of India and identifies the burden hotspots and risk factors. Policymakers may use the findings of the article to develop a roadmap for prevention and control of cholera in India. PMID:28837645

Identification of burden hotspots and risk factors for cholera in India: An observational study.

PubMed

Ali, Mohammad; Sen Gupta, Sanjukta; Arora, Nisha; Khasnobis, Pradeep; Venkatesh, Srinivas; Sur, Dipika; Nair, Gopinath B; Sack, David A; Ganguly, Nirmal K

2017-01-01

Even though cholera has existed for centuries and many parts of the country have sporadic, endemic and epidemic cholera, it is still an under-recognized health problem in India. A Cholera Expert Group in the country was established to gather evidence and to prepare a road map for control of cholera in India. This paper identifies cholera burden hotspots and factors associated with an increased risk of the disease. We acquired district level data on cholera case reports of 2010-2015 from the Integrated Disease Surveillance Program. Socioeconomic characteristics and coverage of water and sanitation was obtained from the 2011 census. Spatial analysis was performed to identify cholera hotspots, and a zero-inflated Poisson regression was employed to identify the factors associated with cholera and predicted case count in the district. 27,615 cholera cases were reported during the 6-year period. Twenty-four of 36 states of India reported cholera during these years, and 13 states were classified as endemic. Of 641 districts, 78 districts in 15 states were identified as "hotspots" based on the reported cases. On the other hand, 111 districts in nine states were identified as "hotspots" from model-based predicted number of cases. The risk for cholera in a district was negatively associated with the coverage of literate persons, households using treated water source and owning mobile telephone, and positively associated with the coverage of poor sanitation and drainage conditions and urbanization level in the district. The study reaffirms that cholera continues to occur throughout a large part of India and identifies the burden hotspots and risk factors. Policymakers may use the findings of the article to develop a roadmap for prevention and control of cholera in India.

Feasibility of a combined camp approach for vector control together with active case detection of visceral leishmaniasis, post kala-azar dermal leishmaniasis, tuberculosis, leprosy and malaria in Bangladesh, India and Nepal: an exploratory study.

PubMed

Banjara, Megha R; Kroeger, Axel; Huda, Mamun M; Kumar, Vijay; Gurung, Chitra K; Das, Murari L; Rijal, Suman; Das, Pradeep; Mondal, Dinesh

2015-06-01

We assessed the feasibility and results of active case detection (ACD) of visceral leishmaniasis (VL), post kala-azar dermal leishmaniasis (PKDL) and other febrile diseases as well as of bednet impregnation for vector control. Fever camps were organized and analyzed in twelve VL endemic villages in Bangladesh, India, and Nepal. VL, PKDL, tuberculosis, malaria and leprosy were screened among the febrile patients attending the camps, and existing bednets were impregnated with a slow release insecticide. Among the camp attendees one new VL case and two PKDL cases were detected in Bangladesh and one VL case in Nepal. Among suspected tuberculosis cases two were positive in India but none in the other countries. In India, two leprosy cases were found. No malaria cases were detected. Bednet impregnation coverage during fever camps was more than 80% in the three countries. Bednet impregnation led to a reduction of sandfly densities after 2 weeks by 86% and 32%, and after 4 weeks by 95% and 12% in India and Nepal respectively. The additional costs for the control programmes seem to be reasonable. It is feasible to combine ACD camps for VL and PKDL along with other febrile diseases, and vector control with bednet impregnation. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Culture and Poverty: A Case Study of a Girl with Special Educational Needs from a Poor Community in South India

ERIC Educational Resources Information Center

Philip, Neetha

2015-01-01

Girls with disabilities from lower economic homes are disadvantaged (in terms of gender, disability and poverty) in India, and are often regarded as useless by their communities. There is a need to improve and provide a chance for self-sufficiency among women with disabilities in India. The purpose of this study was to examine the life-chances…

Anomalous low tropospheric column ozone over eastern India during the severe drought event of monsoon 2002: a case study.

PubMed

Ghude, Sachin D; Kulkarni, Santosh H; Kulkarni, Pavan S; Kanawade, Vijay P; Fadnavis, Suvarna; Pokhrel, Samir; Jena, Chinmay; Beig, G; Bortoli, D

2011-09-01

The present study is an attempt to examine some of the probable causes of the unusually low tropospheric column ozone observed over eastern India during the exceptional drought event in July 2002. We examined horizontal wind and omega (vertical velocity) anomalies over the Indian region to understand the large-scale dynamical processes which prevailed in July 2002. We also examined anomalies in tropospheric carbon monoxide (CO), an important ozone precursor, and observed low CO mixing ratio in the free troposphere in 2002 over eastern India. It was found that instead of a normal large-scale ascent, the air was descending in the middle and lower troposphere over a vast part of India. This configuration was apparently responsible for the less convective upwelling of precursors and likely caused less photochemical ozone formation in the free troposphere over eastern India in July 2002. The insight gained from this case study will hopefully provide a better understanding of the process controlling the distribution of the tropospheric ozone over the Indian region.

Applying appropriate-use criteria to cardiac revascularisation in India.

PubMed

Sood, Neeraj; Ugargol, Allen P; Barnes, Kayleigh; Mahajan, Anish

2016-03-30

The high prevalence of coronary heart disease and dramatic growth of cardiac interventions in India motivate an evaluation of the appropriateness of coronary revascularisation procedures in India. Although, appropriate-use criteria (AUC) have been used to analyse the appropriateness of cardiovascular care in the USA, they are yet to be applied to care in India. In our study, we apply AUC to cardiac care in Karnataka, India, compare our results to international applications of AUC, and suggest ways to improve the appropriateness of care in India. Data were collected from the Vajpayee Arogyashree Scheme, a government-sponsored health insurance scheme in Karnataka, India. These data were collected as part of the preauthorisation process for cardiac procedures. The final data included a random sample of 600 patients from 28 hospitals in Karnataka, who obtained coronary artery bypass grafting or percutaneous coronary intervention between 1 October 2014 and 31 December 2014. We obtained our primary baseline results using a random imputation simulation to fill in missing data. Our secondary outcome measure was a best case-worst case scenario where missing data were filled to give the lowest or highest number of appropriate cases. Of the cases, 86.7% (CI 0.837% to 0.892%) were deemed appropriate, 3.65% (CI 0.023% to 0.055%) were inappropriate and 9.63% (CI 0.074% to 0.123%) were uncertain. The vast majority of cardiac revascularisation procedures performed on beneficiaries of a government-sponsored insurance programme in India were found to be appropriate. These results meet or exceed levels of appropriate use of cardiac care in the USA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Risk factors for tuberculosis among health care workers in South India: a nested case-control study.

PubMed

Mathew, Anoop; David, Thambu; Thomas, Kurien; Kuruvilla, P J; Balaji, V; Jesudason, Mary V; Samuel, Prasanna

2013-01-01

The epidemiology of tuberculosis (TB) among health care workers (HCWs) in India remains under-researched. This study is a nested case-control design assessing the risk factors for acquiring TB among HCWs in India. It is a nested case-control study conducted at a tertiary teaching hospital in India. Cases (n = 101) were HCWs with active TB. Controls (n = 101) were HCWs who did not have TB, randomly selected from the 6,003 subjects employed at the facility. Cases and controls were compared with respect to clinical and demographic variables. The cases and controls were of similar age. Logistic regression analysis showed that body mass index (BMI) <19 kg/m(2) (odds ratio [OR]: 2.96, 95% confidence interval [CI]: 1.49-5.87), having frequent contact with patients (OR: 2.83, 95% CI: 1.47-5.45) and being employed in medical wards (OR: 12.37, 95% CI: 1.38-110.17) or microbiology laboratories (OR: 5.65, 95% CI: 1.74-18.36) were independently associated with increased risk of acquiring TB. HCWs with frequent patient contact and those with BMI <19 kg/m(2) were at high risk of acquiring active TB. Nosocomial transmission of TB was pronounced in locations, such as medical wards and microbiology laboratories. Surveillance of high-risk HCWs and appropriate infrastructure modifications may be important to prevent interpersonal TB transmission in health care facilities. Copyright © 2013 Elsevier Inc. All rights reserved.

The Unani traditional medical system in India: a case study in health behaviour.

PubMed

Izhar, N

1989-01-01

The study examines the practice of Unani traditional medicine in India. The case study is based on the Unani Clinic situated in Aligarh Town; patients, practitioner of Unani medicine, and para-medical staff were interviewed about their patterns of patients' health behaviour, of particular interest was the utilization of Unani medical facilities by people of different age groups and belonging to different socio-economic strata. Observations are made regarding effectiveness of the Unani medical system.

English for Employability: A Case Study of the English Language Training Need Analysis for Engineering Students in India

ERIC Educational Resources Information Center

Clement, A.; Murugavel, T.

2015-01-01

This article examines the effectiveness of English language courses offered in the engineering colleges in India. Many engineering graduates in India are found to be unemployable due to their poor communication skills and lack of confidence. There have been a lot of research papers that have reiterated the importance of improving engineering…

The Bangalore Challenge: Case Studies of the Social Construction of Technology in Elementary Schools

ERIC Educational Resources Information Center

Byker, Erik Jon

2012-01-01

As India aspires to become the information and communication technology (ICT) leader in the world, the education of its children is a primary concern. While India's policymakers expect ICT to usher in promising education changes, there is a limited understanding of how computers are used and negotiated in India's schools. This dissertation is an…

Teaching for "Global Telephony": A Case Study of a Community School for India's 21st Century

ERIC Educational Resources Information Center

Byker, Erik Jon

2015-01-01

Although controversial, perhaps no piece of legislation has the potential to transform India's future more than the Right of Children to Free and Compulsory Education Act (RTE). Upon the passage and enforcement of RTE in 2009, the Indian government instituted a series of wide-ranging reforms to India's education system. For example, the act…

When Does the Researcher (Should) Also Become a Resource for the Bricoleur Teacher? A Review of Ajay Sharma's "Portrait of a Science Teacher as a Bricoleur: A Case Study from India"

ERIC Educational Resources Information Center

Rodriguez, Alberto J.

2008-01-01

This paper provides a critical review essay of Ajay Sharma's "Portrait of a science teacher as a bricoleur: A case study from India." The main focus is two fold. First, arguments are presented to draw attention to how little advances in science teaching and science learning research have impacted teachers' practice and student…

Smoking and Inflammatory Bowel Disease: A Comparison of China, India, and the USA.

PubMed

Wang, Peiqi; Hu, Jun; Ghadermarzi, Shadi; Raza, Ali; O'Connell, Douglas; Xiao, Amy; Ayyaz, Faraz; Zhi, Min; Zhang, Yuanqi; Parekh, Nimisha K; Lazarev, Mark; Parian, Alyssa; Brant, Steven R; Bedine, Marshall; Truta, Brindusa; Hu, Pinjin; Banerjee, Rupa; Hutfless, Susan M

2018-06-04

Cigarette smoking is thought to increase the risk of Crohn's disease (CD) and exacerbate the disease course, with opposite roles in ulcerative colitis (UC). However, these findings are from Western populations, and the association between smoking and inflammatory bowel disease (IBD) has not been well studied in Asia. We aimed to compare the prevalence of smoking at diagnosis between IBD cases and controls recruited in China, India, and the USA, and to investigate the impact of smoking on disease outcomes. We recruited IBD cases and controls between 2014 and 2018. All participants completed a questionnaire about demographic characteristics, environmental risk factors and IBD history. We recruited 337 participants from China, 194 from India, and 645 from the USA. In China, CD cases were less likely than controls to be current smokers (adjusted odds ratio [95% CI] 0.4 [0.2-0.9]). There was no association between current or former smoking and CD in the USA. In China and the USA, UC cases were more likely to be former smokers than controls (China 14.6 [3.3-64.8]; USA 1.8 [1.0-3.3]). In India, both CD and UC had similar current smoking status to controls at diagnosis. Current smoking at diagnosis was significantly associated with greater use of immunosuppressants (4.4 [1.1-18.1]) in CD cases in China. We found heterogeneity in the associations of smoking and IBD risk and outcomes between China, India, and the USA. Further study with more adequate sample size and more uniform definition of smoking status is warranted.

A Case-control Study of Diphtheria in the High Incidence City of Hyderabad, India.

PubMed

Allam, Ramesh Reddy; Uthappa, Chengappa Kechamada; Duerst, Rebecca; Sorley, Evan; Udaragudi, Prasada Rao; Kampa, Shankar; Dworkin, Mark S

2016-03-01

India accounts for approximately 72% of reported diphtheria cases globally, the majority of which occur in the state of Andhra Pradesh. The aim of this study is to better understand lack of knowledge on diphtheria vaccination and to determine factors associated with diphtheria and low knowledge and negative attitudes. We performed a 1:1 case-control study of hospitalized diphtheria cases in Hyderabad. Eligible case patients were 10 years of age or older, resided within the city of Hyderabad and were diagnosed with diphtheria per the case definition. Patients admitted to the hospital for nonrespiratory communicable diseases and residing in the same geographic region as that of cases were eligible for enrolment as controls : There were no statistical differences in disease outcome by gender, education, economic status and mean room per person sleeping in the house in case and control subjects. Not having heard of diphtheria (adjusted odds ratio: 3.56; 95% confidence intervals: 1.58-8.04] and not believing that vaccines can prevent people from getting diseases (adjusted odds ratio: 3.99; 95% confidence intervals: 1.18-13.45) remained significantly associated with diphtheria on multivariate analysis. To reduce the burden of diphtheria in India, further efforts to educate the public about diphtheria should be considered.

Information Technology and the Training and Career Development of Women: The Case of India. Training Discussion Paper No. 30.

ERIC Educational Resources Information Center

Saldanha, Lynette

Information technology (IT) is a growing field in India, with many present and future job opportunities. The field offers expanding opportunities for women, especially in the services sector. Case studies of nine companies that employ a fair number of women in IT showed that, in general, women had equal opportunities with men, especially in…

Practical observations from an epidemiological investigation of a measles outbreak in a district of India.

PubMed

Mishra, Ashok; Mishra, Subodh; Lahariya, Chandrakant; Jain, Pankaj; Bhadoriya, Rahul S; Shrivastav, Dhiraj; Marathe, Neera

2009-04-01

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. 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. 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%. 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.

Malaria in India: The Center for the Study of Complex Malaria in India

PubMed Central

Das, Aparup; Anvikar, Anupkumar R.; Cator, Lauren J.; Dhiman, Ramesh C.; Eapen, Alex; Mishra, Neelima; Nagpal, Bhupinder N.; Nanda, Nutan; Raghavendra, Kamaraju; Read, Andrew F.; Sharma, Surya K.; Singh, Om P.; Singh, Vineeta; Sinnis, Photini; Srivastava, Harish C.; Sullivan, Steven A.; Sutton, Patrick L.; Thomas, Matthew B.; Carlton, Jane M.; Valecha, Neena

2012-01-01

Malaria is a major public health problem in India and one which contributes significantly to the overall malaria burden in Southeast Asia. The National Vector Borne Disease Control Program of India reported ~1.6 million cases and ~1100 malaria deaths in 2009. Some experts argue that this is a serious underestimation and that the actual number of malaria cases per year is likely between 9 and 50 times greater, with an approximate 13-fold underestimation of malaria-related mortality. The difficulty in making these estimations is further exacerbated by (i) highly variable malaria eco-epidemiological profiles, (ii) the transmission and overlap of multiple Plasmodium species and Anopheles vectors, (iii) increasing antimalarial drug resistance and insecticide resistance, and (iv) the impact of climate change on each of these variables. Simply stated, the burden of malaria in India is complex. Here we describe plans for a Center for the Study of Complex Malaria in India (CSCMi), one of ten International Centers of Excellence in Malaria Research (ICEMRs) located in malarious regions of the world recently funded by the National Institute of Allergy and Infectious Diseases, National Institutes of Health. The CSCMi is a close partnership between Indian and United States scientists, and aims to address major gaps in our understanding of the complexity of malaria in India, including changing patterns of epidemiology, vector biology and control, drug resistance, and parasite genomics. We hope that such a multidisciplinary approach that integrates clinical and field studies with laboratory, molecular, and genomic methods will provide a powerful combination for malaria control and prevention in India. PMID:22142788

Workplace Violence and Gender Bias in Unorganized Fisheries of Udupi, India.

PubMed

Tripathi, P; Tiwari, R; Kamath, R

2016-07-01

Fisheries industry in India is an unorganized sector of occupation where considerable proportion of workers is female. However, the prevalent gender inequality in terms of task allocation, wages, and other welfare facilities makes the men as dominant workforce. Furthermore, there are occasions when incidents of workplace violence take place. The present study was conducted to find the prevalence of workplace violence at worksite and study gender bias in such events. In a cross-sectional study 171 fishermen and fisherwomen were interviewed to collect information about workplace violence. The overall prevalence of workplace violence reported was 14.6%. This included 2 (8%) cases of physical assault, 1 (4%) case of sexual harassment of fisherwoman by her colleague and 22 (88%) cases of verbal abuse. A significant (p=0.002) association was found between gender and verbal abuse at the workplace. In conclusion, this study highlighted the occurrence of workplace violence among fishery workers in India. There was a gender bias towards females that can be attributed to male dominance in this occupation.

Segregation, Integration, Inclusion and Effective Provision: A Case Study of Perspectives from Special Educational Needs Children, Parents and Teachers in Bangalore India

ERIC Educational Resources Information Center

Elton-Chalcraft, Sally; Cammack, Paul J.; Harrison, Liz

2016-01-01

Educating special educational needs (SEN) children in special schools is the norm in India but there is a growing trend towards inclusive practice. Perspectives were sought from children, their parents and teachers in Bangalore, India to investigate perceptions of effective provision for SEN children using an interpretative approach to provide…

Economic and Disease Burden of Dengue Illness in India

PubMed Central

Shepard, Donald S.; Halasa, Yara A.; Tyagi, Brij Kishore; Adhish, S. Vivek; Nandan, Deoki; Karthiga, K. S.; Chellaswamy, Vidya; Gaba, Mukul; Arora, Narendra K.

2014-01-01

Between 2006 and 2012 India reported an annual average of 20,474 dengue cases. Although dengue has been notifiable since 1996, regional comparisons suggest that reported numbers substantially underrepresent the full impact of the disease. Adjustment for underreporting from a case study in Madurai district and an expert Delphi panel yielded an annual average of 5,778,406 clinically diagnosed dengue cases between 2006 and 2012, or 282 times the reported number per year. The total direct annual medical cost was US$548 million. Ambulatory settings treated 67% of cases representing 18% of costs, whereas 33% of cases were hospitalized, comprising 82% of costs. Eighty percent of expenditures went to private facilities. Including non-medical and indirect costs based on other dengue-endemic countries raises the economic cost to $1.11 billion, or $0.88 per capita. The economic and disease burden of dengue in India is substantially more than captured by officially reported cases, and increased control measures merit serious consideration. PMID:25294616

Could Homeopathy Become An Alternative Therapy In Dengue Fever? An example Of 10 Case Studies.

PubMed

Mahesh, Seema; Mahesh, Mallappa; Vithoulkas, George

2018-01-01

Background: Dengue fever is one of the most rampant epidemics in India of late and any therapy that may help limit the sickness and hospital admissions is worth considering. In India complementary and alternative medicine physicians are medically trained and hence have a role to play in delivery of public health. Case Series: We present a retrospective case series of 10 Indian patients who were diagnosed with dengue fever and treated exclusively with homeopathic remedies at Bangalore, India. This case series demonstrates with evidence of laboratory reports that even when the platelets dropped considerably there was good result without resorting to any other means. Conclusions: A need for further, larger studies is indicated by this evidence, to precisely define the role of homeopathy in treating dengue fever. This study also emphasises the importance of individualised treatment during an epidemic for favourable results with homeopathy. Abbreviations: DF: dengue fever, NS1: non-structural protein 1 antigen, IgG: immunoglobulin G, IgM: immunoglobulin M, +ve: positive, -ve: negative, WBC: white blood cells, RBC: red blood cells, ESR: erythrocyte sedimentation rate.

Social Factors Determining the Experience of Blindness among Pregnant Women in Developing Countries: The Case of India

ERIC Educational Resources Information Center

Pandey, Shanta; Lin, Yuan; Collier-Tenison, Shannon; Bodden, Jamie

2012-01-01

Approximately 10 million pregnant women around the world develop night blindness annually. In India, one in 11 pregnant women suffers from night blindness. This study used a nationally representative sample of 35,248 women from India between the ages of 15 and 49 who had given birth in the past five years to understand the effect of women's…

Genetic characterization of enterovirus strains identified in Hand, Foot and Mouth Disease (HFMD): Emergence of B1c, C1 subgenotypes, E2 sublineage of CVA16, EV71 and CVA6 strains in India.

PubMed

Ganorkar, Nital N; Patil, Pooja R; Tikute, Sanjay S; Gopalkrishna, Varanasi

2017-10-01

Hand, Foot and Mouth disease (HFMD) is a common childhood disease and caused due to Enterovirus-A (EV-A), EV-B and EV-C species worldwide. Cases of HFMD were reported from, Ahmedabad (Gujarat, 2012) and Pune (Maharashtra, 2013-2014) in India. The present study highlights the identification of EV strains (CVA16, CVA6, CVA4 and Echo12), characterization of subgenotypes of CVA16, CVA6 strains during 2012-14 and CVA16, CVA6, EV71 strains reported from the earlier study (2009-10) in HFMD cases from India. A total 158 clinical specimens collected from 64 HFMD cases (2012-2014) were included in the study. EV detection was carried out by 5'NCR based RT-PCR, molecular typing and subgenotyping was by VP1/2A junction or VP1, full VP1 gene amplification respectively followed by phylogenetic analysis. The present study reports 63.92% (101/158) EV positivity by RT-PCR. Ninety four of the 101 (93.06%) EV positive strains were amplified by VP1/2A junction or VP1 regions. Sequence analysis revealed the presence of CVA16 (61.7%), CVA6 (34.04%), CVA4 and Echo12 (4.3%). A total of 114 EV positive strains were genotyped using full and partial VP1 region. All CVA16 Indian strains (n=70) clustered with rarely reported B1c subgenotype, CVA6 (n=43) and EV71 (n=1) strains clustered with sub-lineage E2 and C1 subgenotypes respectively. In summary, the study reports genetic characterization of CVA16, CVA6, CVA4 and Echo12 strains in HFMD cases from India. Circulation of B1c subgenotype of CVA16, E2 sub-lineage of CVA6 and C1 subgenotype of EV 71 strains in HFMD cases were reported for the first time from India. This study helps to understand the genotype distribution, genetic diversity of EV strains associated with HFMD from Eastern, Western and Southern regions in India. Copyright © 2017 Elsevier B.V. All rights reserved.

Etiology and mode of presentation of chronic liver diseases in India: A multi centric study.

PubMed

Mukherjee, Partha S; Vishnubhatla, Sreenivas; Amarapurkar, Deepak N; Das, Kausik; Sood, Ajit; Chawla, Yogesh K; Eapen, Chundamannil E; Boddu, Prabhakar; Thomas, Varghese; Varshney, Subodh; Hidangmayum, Diamond Sharma; Bhaumik, Pradip; Thakur, Bhaskar; Acharya, Subrat K; Chowdhury, Abhijit

2017-01-01

There is a paucity of health policy relevant data for chronic liver disease from India, impeding formulation of an interventional strategy to address the issue. A prospective, multicentric study to delineate the etiology and clinical profile of chronic liver disease in India is reported here. A centrally coordinated and monitored web-based data repository was developed (Feb, 2010 to Jan, 2013) and analyzed. Eleven hospitals from different parts of India participated. Data were uploaded into a web based proforma and monitored by a single centre according to a standardized protocol. 1.28% (n = 266621) of all patients (n = 20701383) attending the eleven participating hospitals of India had liver disease. 65807 (24·68%) were diagnosed for the first time (new cases). Of these, 13014 (19·77%, median age 43 years, 73% males) cases of chronic liver disease were finally analyzed. 33.9% presented with decompensated cirrhosis. Alcoholism (34·3% of 4413) was the commonest cause of cirrhosis while Hepatitis B (33·3%) was predominant cause of chronic liver disease in general and non-cirrhotic chronic liver disease (40·8% out of 8163). There was significant interregional differences (hepatitis C in North, hepatitis B in East and South, alcohol in North-east, Non-alcoholic Fatty Liver Disease in West) in the predominant cause of chronic liver disease. Hepatitis B (46·8% of 438 cases) was the commonest cause of hepatocellular Cancer.11·7% had diabetes. Observations of our study will help guide a contextually relevant liver care policy for India and could serve as a framework for similar endeavor in other developing countries as well.

Fatal occupational injuries in the South Delhi construction industry: a retrospective study.

PubMed

Rautji, R; Lalwani, S; Dogra, T D

2005-04-01

One hundred and forty-five unselected autopsy cases of construction site accidents received from South Delhi were studied during the period from 1996--2002. Data for the study was gathered from autopsy reports and hospital records. The cases represented approximately 1.61% of all autopsy cases received from South Delhi at the All India Institute of Medical Sciences, New Delhi (India). Data was analysed with regard to the age and sex of the victim, the part of the body involved, the manner of accident, the cause of death and the pattern of injuries in different body regions. Death occurred at the scene of the fatal event in thirty-four cases; forty-three cases were dead on arrival at the hospital; sixty-eight cases died after being admitted to the hospital. Ethanol was detected in the blood of 16% of the cases.

Improving the knowledge of labour and delivery nurses in India: a randomized controlled trial of mentoring and case sheets in primary care centres.

PubMed

Bradley, Janet; Jayanna, Krishnamurthy; Shaw, Souradet; Cunningham, Troy; Fischer, Elizabeth; Mony, Prem; Ramesh, B M; Moses, Stephen; Avery, Lisa; Crockett, Maryanne; Blanchard, James F

2017-01-07

Birthing in health facilities in India has increased over the last few years, yet maternal and neonatal mortality rates remain high. Clinical mentoring with case sheets or checklists for nurses is viewed as essential for on-going knowledge transfer, particularly where basic training is inadequate. This paper summarizes a study of the effect of such a programme on staff knowledge and skills in a randomized trial of 295 nurses working in 108 Primary Health Centres (PHCs) in Karnataka, India. Stratifying by district, half of the PHCs were randomly assigned to be intervention sites and provided with regular mentoring visits where case sheet/checklists were a central job and teaching aid, and half to be control sites, where no support was provided except provision of case sheets. Nurses' knowledge and skills around normal labour, labour complications and neonate issues were tested before the intervention began and again one year later. Univariate and multivariate analyses were conducted to examine the effect of mentoring and case sheets. Overall, on none of the 3 measures, did case sheet use without mentoring add anything to the basic nursing training when controlling for other factors. Only individuals who used both case-sheets and received mentoring scored significantly higher on the normal labour and neonate indices, scoring almost twice as high as those who only used case-sheets. This group was also associated with significantly higher scores on the complications of labour index, with their scores 2.3 times higher on average than the case sheet only control group. Individuals from facilities with 21 or more deliveries in a month tended to fare worse on all 3 indices. There were no differences in outcomes according to district or years of experience. This study demonstrates that provision of case sheets or checklists alone is insufficient to improve knowledge and practices. However, on-site mentoring in combination with case sheets can have a demonstrable effect on improving nurse knowledge and skills around essential obstetric and neonatal care in remote rural areas of India. We recommend scaling up of this mentoring model in order to improve staff knowledge and skills and reduce maternal and neonatal mortality in India. This study is registered at clinicaltrials.gov, Identifier No. NCT02004912 , November 27, 2013.

Malaria in India: the center for the study of complex malaria in India.

PubMed

Das, Aparup; Anvikar, Anupkumar R; Cator, Lauren J; Dhiman, Ramesh C; Eapen, Alex; Mishra, Neelima; Nagpal, Bhupinder N; Nanda, Nutan; Raghavendra, Kamaraju; Read, Andrew F; Sharma, Surya K; Singh, Om P; Singh, Vineeta; Sinnis, Photini; Srivastava, Harish C; Sullivan, Steven A; Sutton, Patrick L; Thomas, Matthew B; Carlton, Jane M; Valecha, Neena

2012-03-01

Malaria is a major public health problem in India and one which contributes significantly to the overall malaria burden in Southeast Asia. The National Vector Borne Disease Control Program of India reported ∼1.6 million cases and ∼1100 malaria deaths in 2009. Some experts argue that this is a serious underestimation and that the actual number of malaria cases per year is likely between 9 and 50 times greater, with an approximate 13-fold underestimation of malaria-related mortality. The difficulty in making these estimations is further exacerbated by (i) highly variable malaria eco-epidemiological profiles, (ii) the transmission and overlap of multiple Plasmodium species and Anopheles vectors, (iii) increasing antimalarial drug resistance and insecticide resistance, and (iv) the impact of climate change on each of these variables. Simply stated, the burden of malaria in India is complex. Here we describe plans for a Center for the Study of Complex Malaria in India (CSCMi), one of ten International Centers of Excellence in Malaria Research (ICEMRs) located in malarious regions of the world recently funded by the National Institute of Allergy and Infectious Diseases, National Institutes of Health. The CSCMi is a close partnership between Indian and United States scientists, and aims to address major gaps in our understanding of the complexity of malaria in India, including changing patterns of epidemiology, vector biology and control, drug resistance, and parasite genomics. We hope that such a multidisciplinary approach that integrates clinical and field studies with laboratory, molecular, and genomic methods will provide a powerful combination for malaria control and prevention in India. Copyright © 2011 Elsevier B.V. All rights reserved.

A psychological profile of a serial killer: a case report.

PubMed

Dogra, T D; Leenaars, Antoon A; Chadha, R K; Manju, Mehta; Lalwani, Sanjeev; Sood, Mamta; Lester, David; Raina, Anupuma; Behera, C

2012-01-01

Serial killers have always fascinated society. A serial killer is typically defined as a perpetrator who murders three or more people over a period of time. Most reported cases of serial killers come from the United States and Canada. In India, there are few reported cases. We present, to the best of our knowledge, the first Indian case in the literature. The present case is of a 28-year-old man, Surinder Koli. The Department of Forensic Medicine & Toxicology, All India Institute of Medical Sciences, New Delphi handled the forensic study. We present a most unique psychological investigation into the mind of a serial killer.

Building and Managing Electronic Resources in Digital Era in India with Special Reference to IUCAA and NIV, Pune: A Comparative Case Study

NASA Astrophysics Data System (ADS)

Sahu, H. K.; Singh, S. N.

2015-04-01

This paper discusses and presents a comparative case study of two libraries in Pune, India, Inter-University Centre for Astronomy and Astrophysics and Information Centre and Library of National Institute of Virology (Indian Council of Medical Research). It compares how both libraries have managed their e-resource collections, including acquisitions, subscriptions, and consortia arrangements, while also developing a collection of their own resources, including pre-prints and publications, video lectures, and other materials in an institutional repository. This study illustrates how difficult it is to manage electronic resources in a developing country like India, even though electronic resources are used more than print resources. Electronic resource management can be daunting, but with a systematic approach, various problems can be solved, and use of the materials will be enhanced.

Civil Society, Adult Learning and Action in India.

ERIC Educational Resources Information Center

Tandon, Rajesh

2000-01-01

Five case studies of individual and collective learning projects in India demonstrate that (1) the impetus for civic action arises from local conditions; (2) transformative action requires sustained adult learning; and (3) civil society is a complex concept reflecting diverse priorities and perspectives. (SK)

Comparative analysis of three prehospital emergency medical services organizations in India and Pakistan.

PubMed

Sriram, V; Gururaj, G; Razzak, J A; Naseer, R; Hyder, A A

2016-08-01

Strengthened emergency medical services (EMS) are urgently required in South Asia to reduce needless death and disability. Several EMS models have been introduced in India and Pakistan, and research on these models can facilitate improvements to EMS in the region. Our objective was to conduct a cross-case comparative analysis of three EMS organizations in India and Pakistan - GVK EMRI, Aman Foundation and Rescue 1122 - in order to draw out similarities and differences in their models. Case study methodology was used to systematically explore the organizational models of GVK EMRI (Karnataka, India), Aman Foundation (Karachi, Pakistan), and Rescue 1122 (Punjab, Pakistan). Qualitative methods - interviews, document review and non-participant observation - were utilized, and using a process of constant comparison, data were analysed across cases according to the WHO health system 'building blocks'. Emergent themes under each health system 'building block' of service delivery, health workforce, medical products and technology, health information systems, leadership and governance, and financing were described. Cross-cutting issues not applicable to any single building block were further identified. This cross-case comparison, the first of its kind in low- and middle-income countries, highlights key innovations and lessons, and areas of further research across EMS organizations in India, Pakistan and other resource-poor settings. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Chromobacterium violaceum septicaemia from north India.

PubMed

Ray, Pallab; Sharma, Jyoti; Marak, Rungmei S K; Singhi, S; Taneja, Neelam; Garg, Raj Kumar; Sharma, Meera

2004-12-01

Though Chromobacterium violaceum is a common inhabitant of soil and water in tropical and sub-tropical regions, human infections are rare but when they do occur result in high mortality. Since the first case from Malaysia in 1927, about 150 cases have been reported in world literature. Till date 6 cases have been reported from southern and eastern parts of India. We report here a case of C. violaceum septicaemia, probably the first case from north India. The patient, a 6 and a half year old boy was admitted with high fever. The patient had anaemia, neutrophilic leucocytosis and bilateral chest infiltrates. Routine and bacteriological investigations were carried out to establish the aetiological diagnosis. C. violaceum was isolated in pure culture from blood and pus. The patient was successfully treated with ciprofloxacin and amikacin. This is probably the first documented case report of C. violaceum infection from north India and the only Indian case with septicaemia which survived.

Pathologic lesions in children with acquired immunodeficiency syndrome an autopsy study of 11 cases from Mumbai, India.

PubMed

Lanjewar, Dhanesheshwar N; Bhatia, Varsha Omprakash; Lanjewar, Sonali Dhaneshwar

2016-01-01

Human immunodeficiency virus (HIV) infection in India has now been prevalent over three decades, and an increasing number of children are being affected with HIV. The spectrum of pathologic lesions in children with acquired immunodeficiency syndrome (AIDS) in India has not been well described. A review of systematically conducted autopsies of 11 (10 boys and 1 girl) children with AIDS is presented. The mode of HIV transmission in 6 children was vertical; in one it was blood transfusion and in 4 children route was presumably vertical as these were children of orphanage. The clinical manifestations were failure to thrive; 9 children, persistent gastroenteritis; 8, recurrent fever; 5, bacterial infections; 5, hepatosplenomegaly; 5, candidiasis; 1, scabies; 1, skin rash; 2, tuberculous (TB) meningitis; 1 and paraplegia; in 1 child. The spectrum of pathologic lesions observed were precocious involution in thymus in 3 and dysinvolution in 2 cases. Infectious diseases comprised of TB; 4 cases, cytomegalovirus infection (CMV) 4; bacterial pneumonia and meningitis; 7, and esophageal candidiasis in 2 cases. Dual or multiple infections were observed in 9 (82%) cases; these comprised of two lesions in 2, three lesions in 2, four lesions in 4, and five lesions in 1 case. TB, bacterial pneumonia, meningitis, and CMV infection are the most frequent causes of death in children with AIDS. Vascular lesions showing features of arteriopathy were observed in 5 cases and brain in one case showed non-Hodgkin's lymphoma. This study provides a better insight into the spectrum of pathologic lesions in children with AIDS in India. TB and CMV infection has been found to be the most prevalent infection in our children.

Social Stratification and Mobility in a Rural Community (Mahi) in Gujarat, India.

ERIC Educational Resources Information Center

Panchanadikar, K. C.; Panchanadikar, J.

Analyzing the interaction between factors that are stable and factors that initiate change re: promotion of social mobility or crystalization of existing social stratification, this paper presents a case study of Mahi, a rural village in Gujarat, India. Utilizing data derived from two field studies (1961-1962 and March 1967-June 1967), the stable…

e-Agriculture Prototype for Knowledge Facilitation among Tribal Farmers of North-East India: Innovations, Impact and Lessons

ERIC Educational Resources Information Center

Raj, Saravanan

2013-01-01

Purpose: This case study deals with the implementation methodology, innovations and lessons of the ICT initiative in providing agricultural extension services to the rural tribal farming community of North-East India. Methodology: This study documents the ICT project implementation challenges, impact among farmers and briefly indicates lessons of…

Secondary School Teachers' Perception of Corporal Punishment: A Case Study in India

ERIC Educational Resources Information Center

Cheruvalath, Reena; Tripathi, Medha

2015-01-01

This article examines secondary school teachers' perceptions of corporal punishment in India. Although it has been banned in Indian schools, various types of corporal punishment are still used by teachers. It has been mainly used as a mechanism for controlling disciplinary problems in schools. Based on a pilot study of 160 secondary teachers, the…

Digital Scholarship and Resource Sharing Among Astronomy Libraries: A Case Study of RRI Library

NASA Astrophysics Data System (ADS)

Benegal, V.

2012-08-01

Prior to developing consortia, astronomy libraries in India were in an embryonic stage with meager resources and dwindling budgets. It was extremely difficult for them to respond to the needs of their users. Librarians at the various Indian astronomy institutes were forced to look at alternate strategies. Raman Research Institute in Bangalore will be examined in a case study where they attempt to implement resource sharing with other institutes in India and how they were able to provide efficient service to the astronomy community.

Politics and Health at the WHO Regional Office for South East Asia: The Case of Portuguese India, 1949-61.

PubMed

Saavedra, Monica

2017-07-01

This paper analyses how the 1950-61 conflict between Portugal and India over the territories that constituted Portuguese India (Goa, Daman and Diu) informed Portugal's relations with the World Health Organization's Regional Office for South East Asia (SEARO). The 'Goa question' determined the way international health policies were actually put into place locally and the meaning with which they were invested. This case study thus reveals the political production of SEARO as a dynamic space for disputes and negotiations between nation-states in decolonising Asia. In this context, health often came second in the face of contrasting nationalistic projects, both colonial and post-colonial.

Fifty years of stroke researches in India

PubMed Central

Banerjee, Tapas Kumar; Das, Shyamal Kumar

2016-01-01

Currently, the stroke incidence in India is much higher than Western industrialized countries. Large vessel intracranial atherosclerosis is the commonest cause of ischemic stroke in India. The common risk factors, that is, hypertension, diabetes, smoking, and dyslipidemia are quite prevalent and inadequately controlled; mainly because of poor public awareness and inadequate infrastructure. Only a small number of ischemic stroke cases are able to have the benefit of thrombolytic therapy. Benefits from stem cell therapy in established stroke cases are under evaluation. Presently, prevention of stroke is the best option considering the Indian scenario through control and/or avoiding risk factors of stroke. Interventional studies are an important need for this scenario. PMID:27011621

Mediastinal Adenopathy in India: Through the Eyes of Endobranchial Ultrasound.

PubMed

Dhamija, Amit; Basu, Arup; Sharma, Vishal; Bakshi, Pooja; Verma, Kusum

2015-09-01

Aetiology of mediastinal adenopathy is likely to vary with geographic location and socioeconomic status of a population. Whilst most of adenopathy in the West could be attributed to malignant disorders, causes of the same in a developing country like India has not been extensively studied earlier due to lack of less invasive tools to sample these nodes for cytological and microbiological analysis. Endobronchial ultrasound (EBUS) helps us reach these nodes as a minimally invasive procedure to take aspirations under real-time ultrasound guidance. The aim of the present study is to study the aetiology of mediastinal adenopathy in our population with the help of EBUS. This was a retrospective analysis of all EBUS procedures done by the authors and the diagnosis thus obtained at Sir Ganga Ram Hospital, New Delhi, India between April 2010 and December 2011. A total of 300 patients underwent EBUS in the above period. Most common aetiology encountered in our population was a granulomatous disorder (53% cases) like tuberculosis and sarcoidosis whilst malignancy was third in order of diagnosis (17% cases). Lymph node enlargement due to anthracosis was another uncommon aetiology encountered in the study (5% cases). Benign granulomatous disorders like tuberculosis and sarcoidosis are the most common causes of mediastinal adenopathy in our population. EBUS is proving its worth for diagnosing mediastinal adenopathy. © Journal of the Association of Physicians of India 2011.

Treatment options and barriers to case management of neonatal pneumonia in India: a protocol for a scoping review.

PubMed

Nair, N Sreekumaran; Lewis, Leslie Edward; Murthy, Shruti; Godinho, Myron Anthony; Lakiang, Theophilus; Venkatesh, Bhumika T

2017-09-15

India contributes to the highest neonatal deaths globally. Case management is said to be the cornerstone of pneumonia control. Much of the published evidence focuses on children aged 1 to 59 months. This scoping review, thus, aims to identify the treatment options for and barriers to case management of neonatal pneumonia in India. This protocol is part of a series of three reviews on neonatal pneumonia in India. Studies addressing treatment of or barriers to case management of neonatal pneumonia in Indian context, published in English in peer-reviewed and indexed journals will be eligible for inclusion. Electronic search will be conducted on nine databases. Hand searching and snowballing will be done for published and grey literature. Selection of studies will be done in title, abstract and full-text stages. A narrative summary will be performed to summarise the details of evidence. As this is a review involving analysis of secondary data which is available in the public domain and does not involve human participants, ethical approval was not required. The findings of the study will be shared with all stakeholders of this research. Knowledge dissemination workshops will be conducted with relevant stakeholders to ultimately transfer the evidence tailored to the stakeholder (eg, policy briefs, publications, information booklets and so on). PROSPERO 2016: CRD42016045449. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Trends, prospects and deprivation index of disability in India: Evidences from census 2001 and 2011.

PubMed

Awasthi, Ashish; Pandey, C M; Dubey, Manisha; Rastogi, Sanjay

2017-04-01

Since the dawn of civilization, disabilities have existed in various dimensions of human life. World Health Organization (WHO) defines disability as an umbrella term, covering impairments, activity limitations, and participation restrictions. Globally, approximately 1 billion people have some form of disability, and approximately 20% have significant functioning impairments. This study aims to estimate the level, trends and prospects of disability in 640 districts of India. Data for the present study has been taken from Census of India, 2001 and 2011. A Disability Index was calculated at the district level, and state level indexing was done using the Disability Deprivation Index. The population for the year 2021 was projected using the exponential growth rate method. The Disability Deprivation Index was calculated using child labor, adult unemployment, illiteracy, and the ratio of beggars in the disabled population. The study reveals that the proportion of the disabled population in India was 2.10% in 2001, which increased to 2.21% in 2011. According to the Disability Deprivation Index, Maharashtra was the best-performing state in 2011. There were 4.90 million new cases of disability in India during 2001-11, out of which 1.52 million cases belonged to non-congenital disability. There is a rise in the disabled population in India, which needs special attention. The working status of the disabled is gloomy. The majority of the disabled people are non-working and need adequate rehabilitation measures that would facilitate employment. Copyright © 2016 Elsevier Inc. All rights reserved.

Efficacy of extracts of Bacillus thuringiensis israelensis for the control of mosquito vectors.

USDA-ARS?s Scientific Manuscript database

More than 1 million human cases of Chikungunya were recently reported in India. Aedes aegypti (the yellow fever mosquito) is an important disease vector in India where it transmits Chikungunya, dengue, and yellow fever viruses to humans. In this study, scientists from Bharathiar University in Coim...

Spectrum of perforation peritonitis in India--review of 504 consecutive cases.

PubMed

Jhobta, Rajender Singh; Attri, Ashok Kumar; Kaushik, Robin; Sharma, Rajeev; Jhobta, Anupam

2006-09-05

Perforation peritonitis is the most common surgical emergency in India. The spectrum of etiology of perforation in Tropical countries continues to be different from its Western counterpart. The objective of the study was to highlight the spectrum of perforation peritonitis as encountered by us at Government Medical College and Hospital (GMCH), Chandigarh. Five hundred and four consecutive cases of perforation peritonitis over a period of five years were reviewed in terms of clinical presentation, operative findings and postoperative course retrospectively at GMCH, Chandigarh. The most common cause of perforation in our series was perforated duodenal ulcer (289 cases) followed by appendicitis (59 cases), gastrointestinal perforation due to blunt trauma abdomen (45 cases), typhoid fever (41 cases) and tuberculosis (20 cases). Despite delay in seeking medical treatment (53%), the overall mortality (10%) was favourably comparable with other published series though the overall morbidity (50%) was unusually high. In contrast to western literature, where lower gastrointestinal tract perforations predominate, upper gastrointestinal tract perforations constitute the majority of cases in India. The increasing incidence of post-traumatic gastro-enteric injuries may be due to an increase in high speed motor vehicle accidents which warrant early recognition and prompt treatment to avoid serious complications and death.

Coordination between Education and Population Policies--A Case Study of India.

ERIC Educational Resources Information Center

Chawla, S. P.

Population and educational policies of the government of India since 1950 are reviewed. A major objective of the study is to take stock of accomplishments and problems in the two policy areas so that policymakers will have up to date information upon which to base future planning. The document is presented in seven chapters. Chapter I offers an…

Sociotechnical Narratives in Rural, High-Poverty Elementary Schools: Comparative Findings from East Texas and South India

ERIC Educational Resources Information Center

Byker, Erik J.

2014-01-01

The article's purpose is to compare case studies of computer technology use at two rural elementary schools across two international settings. This study uses the Social Construction of Technology (SCOT) theory to guide this comparative investigation of how elementary school teachers and students in East Texas and South India construct meaning for…

Privatisation Policies and Postprivatisation Control Devices in India's Higher Education: Evidence from a Regional Study and Implications for Developing Countries

ERIC Educational Resources Information Center

Narayana, M. R.

2006-01-01

This article focuses on economic analysis of privatisation policies and postprivatisation control devices in India's higher education. As a case study, the experiences of Karnataka State in collegiate education under general higher education are emphasised. A change in public financing, rather than a shift of public ownership and management to…

Chickenpox outbreak in a tribal and industrial zone from the Union Territory of Dadra and Nagar Haveli, India.

PubMed

Vaidya, S R; Tilavat, S M; Kumbhar, N S; Kamble, M B

2018-03-01

During 9th December 2016 and 12th February 2017, 149-chickenpox cases were reported in a tribal and industrial zone of Rakholi (n = 80) and Surangi (n = 69) villages from Union Territory of India. An epidemiological investigation was performed to assess the characteristics and determinants of the chickenpox outbreak. Overall, the attack rate per 100 population in Rakholi village (n = 1757) was 4.5% and 19.1% in Surangi village (n = 360). Ages of the cases were ranged from 6 months to 55 years and there were 53 females and 96 males. For the laboratory investigations, 25 serum samples, three urine specimens, three throat swabs and six blister/skin swabs were collected from 37-suspected chickenpox cases. Altogether, 30-suspected cases were laboratory confirmed by either IgM EIA or varicella zoster virus (VZV) DNA PCR. Both VZV-specific IgM and IgG antibodies were detected in 19-suspected cases. Two suspected cases showed the presence of VZV-specific IgG antibodies but not IgM antibodies. On the contrary, three suspected cases showed VZV-specific IgM but not IgG antibodies. Overall, 31 of 37-suspected cases (including one equivocal case) were laboratory confirmed. The partial sequencing of ORF-28 gene of VZV revealed circulation of clade-1 viruses. In conclusion, this investigation provides detail information about the chickenpox outbreak in the tribal and industrial setting from India. Furthermore, the study emphasises the need to investigate more chickenpox outbreaks in different parts of India.

Progress toward poliomyelitis eradication--India, January 2007-May 2009.

PubMed

2009-07-10

India is the most populous of the four remaining countries (including Afghanistan, Nigeria, and Pakistan) where transmission of wild poliovirus (WPV) has never been interrupted. The last cases of WPV type 2 worldwide were reported in October 1999 in India. However, transmission of WPV type 1 (WPV1) and WPV type 3 (WPV3) persists in India in the northern states of Uttar Pradesh and Bihar. Transmission of indigenous WPV in all of India's other states was successfully interrupted in 2002, and all WPV cases reported since then in the country have resulted from WPV circulating in Uttar Pradesh and Bihar. This report updates previous reports and summarizes India's progress toward polio eradication since January 2007, as of May 29, 2009. In 2005, the government of India introduced the use of monovalent oral polio vaccine type 1 (mOPV1), which has higher efficacy against WPV1 than does trivalent oral polio vaccine (tOPV), in supplementary immunization activities. After a multistate WPV1 outbreak in 2006, preferential use of mOPV1 was accelerated and WPV1 cases decreased from 83 in 2007 to 18 during January-May 2009. A resurgence of WPV3 cases in Uttar Pradesh in 2007 led to an outbreak in Bihar. SIAs using monovalent type 3 OPV (mOPV3) were expanded in 2007, and the number of WPV3 cases declined from 794 in 2007 to 41 during January-May 2009. Simultaneously interrupting transmission in high-risk areas of western Uttar Pradesh and Bihar is the key to successful interruption of all WPV transmission in India.

Survey of tuberculosis drug resistance among Tibetan refugees in India.

PubMed

Salvo, F; Dorjee, K; Dierberg, K; Cronin, W; Sadutshang, T D; Migliori, G B; Rodrigues, C; Trentini, F; Di Serio, C; Chaisson, R; Cirillo, D M

2014-06-01

Tuberculosis (TB) is a major health problem among Tibetans living in exile in India. Although drug-resistant TB is considered common in clinical practice, precise data are lacking. To determine the proportion of drug-resistant cases among new and previously treated Tibetan TB patients. In a drug resistance survey in five Tibetan settlements in India, culture and drug susceptibility testing (DST) for first-line drugs were performed among all consecutive new and previously treated TB cases from April 2010 to September 2011. DST against kanamycin (KM), ethionamide, para-aminosalicylic acid and ofloxacin (OFX) was performed on multidrug-resistant TB (MDR-TB) isolates. Of 307 patients enrolled in the study, 264 (193 new and 71 previously treated) were culture-positive and had DST available. All patients tested for the human immunodeficiency virus (n = 250) were negative. Among new TB cases, 14.5% had MDR-TB and 5.7% were isoniazid (INH) monoresistant. Among previously treated cases, 31.4% had MDR-TB and 12.7% were INH-monoresistant. Of the MDR-TB isolates, 28.6% of new and 26.1% of previously treated cases were OFX-resistant, while 7.1% of new cases and 8.7% of previously treated cases were KM-resistant. Three patients had extensively drug-resistant TB. MDR-TB is common in new and previously treated Tibetans in India, who also show additional complex resistance patterns. Of particular concern is the high percentage of MDR-TB strains resistant to OFX, KM or both.

[Current development of acupuncture-moxibustion in India:a case study of West Bengal].

PubMed

Yang, Yuyang; Liu, Jingyuan; Luo, Lu

2017-03-12

Acupuncture-moxibustion was introduced to India in mid-20th century and has been legislated in two provinces in India where the registration of acupuncture practitioners is implemented at present. In India, the central government recognizes that acupuncture-moxibustion is an approach of treatment and is permitted by the licensed doctor. Because of the weakness of the basic development of acupuncture-moxibustion in India, the go-vernment put great effort to support and protect their national traditional medicine. Acupuncture-moxibustion development is mainly in the folk and in the progression for the provincial and governmental legislation. In the paper, by taking West Bengal as example, the legislation, clinical application, education and scientific research of acupuncture-moxibustion are analyzed so that an approach is explored for the further development of acupuncture-moxibustion in India.

Study on the Prevalence of Leptospirosis among Fever Cases Reported from Private Clinics in the Urban areas of Villupuram District, Tamil Nadu, India

PubMed Central

Basker, Parasuraman; Kannan, Pichai; Kolandaswamy, Karumana Gounder

2014-01-01

Objectives To know the prevalence of leptospirosis cases reported in private clinics among fever cases in Villupuram District, Tamil Nadu, India to know its real magnitude of the problem and to diagnose Leptospirosis among fever cases from differential diagnosis. Methods 1502 Blood serum samples collected from three urban towns namely Kallakurichi (Latitude: 11° 73′ N; Longitude: 78° 97′ E), Villupuram (Latitude: 11° 75′ N; Longitude: 79° 92′ E) and Thindivanam (Latitude: 12° 25′ N; Longitude: 79° 65′ E) in fifteen clinics based on case definition of leptospirosis delineated by the National Vector Borne Disease Control Programme (NVBDCP), Government of India. Samples were tested in the laboratory of the Zonal Entomological Team (ZET), Cuddalore with Macroscopic Slide Agglutination Test (MSAT) and Ig-M ELISA. Result There were 65 positive cases detected from 1502 blood serum samples in both MSAT and Ig-M ELISA. It could be known that there was 4% cases contributed from private clinics among fever cases. From this study, further it was known that all age groups of people affected irrespective of sexes based on their living condition associated with the environment prevailed of the disease. Conclusion From this study, it was quantified that 4% of cases reported in private clinics among fever cases and its findings ascertained both the importance of differential diagnosis as well as reports that should be included to the Government for knowing its real magnitude for planning. PMID:24955313

Case-Control Study of Breast Cancer in India: Role of PERIOD3 Clock Gene Length Polymorphism and Chronotype

PubMed Central

Wirth, Michael D.; Burch, James B.; Hébert, James R.; Kowtal, Pradnya; Kapoor, Aparna; Steck, Susan E.; Hurley, Thomas G.; Gupta, Prakash C.; Pednekar, Mangesh S.; Youngstedt, Shawn D.; Zhang, Hongmei; Sarin, Rajiv

2014-01-01

Background This study examined a PERIOD3 (PER3) gene variable number tandem repeat polymorphism and chronotype as potential BrCA risk factors among Indian women. Methods This case-control study included sporadic, histologically confirmed BrCA cases (n=255) and controls (n=249) from India with data collection from 2010–2012. Results Women with the 4/5 or 5/5 PER3 genotype had a non-statistically significant 33% increased odds of BrCA. BrCA cases were more likely to have a morning (OR=2.43, 95% CI=1.23–4.81) or evening (OR=2.55, 95% CI=1.19–5.47) chronotype. Conclusions Findings are consistent with the possibility that extremes in chronotype may elicit circadian desynchronization, resulting in adverse health outcomes. PMID:24903750

Politics and Health at the WHO Regional Office for South East Asia: The Case of Portuguese India, 1949–61

PubMed Central

Saavedra, Monica

2017-01-01

This paper analyses how the 1950–61 conflict between Portugal and India over the territories that constituted Portuguese India (Goa, Daman and Diu) informed Portugal’s relations with the World Health Organization’s Regional Office for South East Asia (SEARO). The ‘Goa question’ determined the way international health policies were actually put into place locally and the meaning with which they were invested. This case study thus reveals the political production of SEARO as a dynamic space for disputes and negotiations between nation-states in decolonising Asia. In this context, health often came second in the face of contrasting nationalistic projects, both colonial and post-colonial. PMID:28604290

Internationalisation and Standardisation of European Environmental Assessment. Relevance to India

ERIC Educational Resources Information Center

Gazzola, Paola; Jha-Thakur, Urmila

2009-01-01

This paper discusses the rationale underlying "PENTA", an EU funded Erasmus Mundus project. In doing so, it explores the challenges of internationalising and standardising European environmental assessment (EA) practice and education to a third country audience, looking at India as a case study. It is argued that the EU EA Directives are…

Undergraduate Engineering Students' Attitudes and Perceptions towards "Professional Ethics" Course: A Case Study of India

ERIC Educational Resources Information Center

Sethy, Satya Sundar

2017-01-01

"Professional Ethics" has been offered as a compulsory course to undergraduate engineering students in a premier engineering institution of India. It was noticed that students' perceptions and attitudes were frivolous and ornamental towards this course. Course instructors and institution authorities were motivated to find out the factors…

Teachers' Perspective on Institutional Barriers to Academic Entrepreneurship--A Case of Uttarakhand State, India

ERIC Educational Resources Information Center

Sharma, Lalit

2017-01-01

The study explores the institutional factors which influence the impact of education in building academic entrepreneurship in higher educational institutes of Uttarakhand state, India. In order to understand the institutional barriers, the author interviewed 68 senior-level educationists, who were working in the capacity of Director General,…

The Challenges of Spanish Language Teaching in Multilingual India: A Case Study of Delhi

ERIC Educational Resources Information Center

Rai, Dhiraj Kumar

2017-01-01

The multilingual surrounding of Spanish Language Teaching (SLT) in India has presented a unique linguistic principle. This principle relies upon the application of English language instructions (as FL1) to combine several methods for teaching-learning Spanish language (as FL2). However, the effectiveness and appropriateness of this linguistic…

A case report of suspected malignant hyperthermia where patient survived the episode.

PubMed

Iqbal, Asif; Badoo, Shoaib; Naqeeb, Ruqsana

2017-01-01

Malignant hyperthermia is rare inherited disorder in our part of the world; there are only few cases reported in literature in India who were suspected of having this condition. The overall incidence of malignant hyperthermia during general anesthesia is estimated to range from 1: 5000 to 1: 50,000-100,000 and mortality rate is estimated to be <5% in the presence of standard care. In India, there is no center where in vitro halothane caffeine contraction test is performed to confirm diagnosis in suspected cases. Second, dantrolene drug of choice for this condition is not freely available in market in India and is stored only in some hospitals in few major cities. Among the cases reported of suspected of malignant hyperthermia in India almost 50% have survived the condition despite nonavailability of dantrolene emphasizing role of early detection and aggressive management in these cases.

A case report of suspected malignant hyperthermia where patient survived the episode

PubMed Central

Iqbal, Asif; Badoo, Shoaib; Naqeeb, Ruqsana

2017-01-01

Malignant hyperthermia is rare inherited disorder in our part of the world; there are only few cases reported in literature in India who were suspected of having this condition. The overall incidence of malignant hyperthermia during general anesthesia is estimated to range from 1: 5000 to 1: 50,000–100,000 and mortality rate is estimated to be <5% in the presence of standard care. In India, there is no center where in vitro halothane caffeine contraction test is performed to confirm diagnosis in suspected cases. Second, dantrolene drug of choice for this condition is not freely available in market in India and is stored only in some hospitals in few major cities. Among the cases reported of suspected of malignant hyperthermia in India almost 50% have survived the condition despite nonavailability of dantrolene emphasizing role of early detection and aggressive management in these cases. PMID:28442967

Adoption of Web 2.0 Technology in Higher Education: A Case Study of Universities in National Capital Region, India

ERIC Educational Resources Information Center

Tyagi, Sunil

2012-01-01

The present study was conducted in six (6) Indian Universities at NCR (National Capital Region) of India to explore the usage analysis of Web 2.0 technologies in learning environment by faculty members. The investigator conducted a survey with the help of structured questionnaire on 300 respondents. A total of 300 self-administered questionnaires…

The Rajasthan Canal Project: A Case Study of Economic Development. Toward a Better World Series, Learning Kit No. 2.

ERIC Educational Resources Information Center

Baldwin, Harriet; Ross-Larson, Bruce, Ed.

This World Bank (Washington, D.C.) kit is designed to teach secondary school social studies students about the Rajasthan (India) Canal Project and the impact it has had on the state of Rajasthan and its population. The kit contains a pamphlet, a booklet, a sound filmstrip, and a teacher's guide. The pamphlet, "Economic Summary: India,"…

Changing patterns and trends of multidrug-resistant tuberculosis at referral centre in Northern India: a 4-year experience.

PubMed

Maurya, A K; Singh, A K; Kumar, M; Umrao, J; Kant, S; Nag, V L; Kushwaha, R A S; Dhole, T N

2013-01-01

India has a high burden of drug-resistant tuberculosis (TB), although there is little data on multidrug-resistant tuberculosis (MDR-TB). Although MDR-TB has existed for long time in India, very few diagnostic laboratories are well-equipped to test drug sensitivity. The objectives of this study were to determine the prevalence of MDR-TB, first-line drug resistance patterns and its changing trends in northern India in the 4 years. This was a prospective study from July 2007 to December 2010. Microscopy, culture by Bactec460 and p-nitro-α-acetylamino-β-hydroxypropiophenone (NAP) test was performed to isolate and identify Mycobacterium tuberculosis (M. tb) complex (MTBC). Drug sensitivity testing (DST) was performed by 1% proportional method (Bactec460) for four drugs: Rifampicin, isoniazid, ethambutol and streptomycin. Various clinical and demographical profiles were evaluated to analyse risk factors for development of drug resistance. We found the overall prevalence rate of MDR-TB to be 38.8%, increasing from 36.4% in 2007 to 40.8% in 2010. we found that the prevalence of MDR-TB in new and previously treated cases was 29.1% and 43.3% ( P < 0.05; CI 95%). The increasing trend of MDR-TB was more likely in pulmonary TB when compared with extra-pulmonary TB ( P < 0.05; CI 95%). we found a high prevalence (38.8%) of MDR-TB both in new cases (29.1%) and previously treated cases (43.3%).This study strongly highlights the need to make strategies for testing, surveillance, monitoring and management of such drug-resistant cases.

Kerosene-a toddler's sin: A five years study at tertiary care hospital in western India.

PubMed

Parekh, Utsav; Gupta, Sanjay

2017-04-01

Acute kerosene poisoning is a preventable health problem in children perceived mainly in developing countries. It influences socioeconomic and cultural status of country due to its contribution in morbidity and mortality. As kerosene is widely used as household energy source in India at rural areas as well as urban, it accounts for significant number of poisoning cases mainly accidental in manner. As there are only handful studies from India on kerosene poisoning in children, we planned this study to evaluate incidence of kerosene poisoning in Western Indian population and its clinico-epidemiotoxicological profile. In this retrospective cross-sectional study, we collected data of all the cases of kerosene poisoning diagnosed during five years from 2009 to 2013 at Shri Krishna hospital situated at Karamsad, Gujarat state of Western India. We observed among total 42 cases, all victims were under 3 years of age. Evening in summer months, rural areas, storage of kerosene in household containers, inadequate parental supervision and door-to-hospitalization period emerged as most serious associated factors. Fever, cough, vomiting, tachypnoea and leucocytosis were commonest manifestations while pneumonia was the most common complication. Signs of central nervous system involvement, leucocytosis and vomiting were significantly correlated with pneumonia. Deaths occurred due to pneumonia. Early diagnosis and treatment of pneumonia may reduce mortality and recommendations are made to reduce the incidence of kerosene poisoning. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Fatal corrosive attack: a study of 13 cases from central Delhi, India.

PubMed

Behera, C; Rani, A; Pradhan, M; Dikshit, P C

2014-06-01

The present study is a retrospective analysis of 13 cases of deaths, which resulted from throwing of corrosives over the body. The cases were autopsied at the Department of Forensic Medicine, Maulana Azad Medical College & Associated Hospitals, Delhi, India, during a period of 13 years from July 1998 to June 2011. The cases represented approximately 0.1% of all autopsy cases during the same period. Data were analyzed with regard to the age, sex, place of occurrence, pattern of injury, survival period, and cause of death. Of these cases, 8 (61.54%) were male, and 5 (38.46%) were female. The most common age group of the victim was 21 to 30 years (46.15%). Six of the victims were attacked on the road side. Face and thorax were involved in all cases (100%). The average total body surface area of burn was 56.69%.The mean survival period was 28.2 days. In 53.85% of cases, the cause of death was septicemia.

C-Window Peaks on CE-HPLC are Extremely Rare in Northern India, and Only Infrequently Represent HbC.

PubMed

Dass, Jasmita; Mittal, Suchi; Saraf, Amrita; Kotwal, Jyoti

2018-01-01

Hemoglobin C (HbC, HBB:c.19G > A) is a structural variant that has been reported rarely from India. This was a retrospective review of all high performance liquid chromatography (HPLCs) submitted over a 14 year period to a tertiary care center in North India with an aim of finding hemoglobins that elute in the C-window. Of the 32,364 HPLCs screened, 6 cases showed peaks in the C-window. Of these 6 cases, only two cases contained hemoglobin C. These was one case each of HbC/β thalassemia and compound heterozygosity for HbC and HbD. There were 4 cases which showed very similar red cell indices and chromatograms with multiple peaks eluting in D-window, C-window and an additional peak with a retention time of 4.74 min. These four cases were compound heterozygous for an α chain variant HbQ-India and a β-chain variant HbD.

El Niño Southern Oscillation as an early warning tool for malaria outbreaks in India.

PubMed

Dhiman, Ramesh C; Sarkar, Soma

2017-03-20

Risks of malaria epidemics in relation to El Niño and Southern Oscillation (ENSO) events have been mapped and studied at global level. In India, where malaria is a major public health problem, no such effort has been undertaken that inter-relates El Niño, Indian Summer Monsoon Rainfall (ISMR) and malaria. The present study has been undertaken to find out the relationship between ENSO events, ISMR and intra-annual variability in malaria cases in India, which in turn could help mitigate the malaria outbreaks. Correlation coefficients among 'rainfall index' (ISMR), '+ winter ONI' (NDJF) and 'malaria case index' were calculated using annual state-level data for the last 22 years. The 'malaria case index' representing 'relative change from mean' was correlated to the 4 month (November-February) average positive Oceanic Niño Index (ONI). The resultant correlations between '+ winter ONI' and 'malaria case index' were further analysed on geographical information system platform to generate spatial correlation map. The correlation between '+ winter ONI' and 'rainfall index' shows that there is great disparity in effect of ENSO over ISMR distribution across the country. Correlation between 'rainfall index' and 'malaria case index' shows that malaria transmission in all geographical regions of India are not equally affected by the ISMR deficit or excess. Correlation between '+ winter ONI' and 'malaria case index' was found ranging from -0.5 to + 0.7 (p < 0.05). A positive correlation indicates that increase in El Niño intensity (+ winter ONI) will lead to rise in total malaria cases in the concurrent year in the states of Orissa, Chhattisgarh, Jharkhand, Bihar, Goa, eastern parts of Madhya Pradesh, part of Andhra Pradesh, Uttarakhand and Meghalaya. Whereas, negative correlations were found in the states of Rajasthan, Haryana, Gujarat, part of Tamil Nadu, Manipur, Mizoram and Sikkim indicating the likelihood of outbreaks in La Nina condition. The generated map, representing spatial correlation between ' + winter ONI' and 'malaria case index', indicates positive correlations in eastern part, while negative correlations in western part of India. This study provides plausible guidelines to national programme for planning intervention measures in view of ENSO events. For better resolution, district level study with inclusion of IOD and 'epochal variation of monsoon rainfall' factors at micro-level is desired for better forecast of malaria outbreaks in the regions with 'no correlation'.

Tetanus - still a scourge in the 21st century: a paediatric hospital-based study in India.

PubMed

Mishra, Kirtisudha; Basu, Srikanta; Kumar, Dipti; Dutta, Ashok Kumar; Kumar, Praveen; Rath, Bimbadhar

2012-07-01

Tetanus remains endemic in India. A retrospective hospital-based study was conducted to review the profile of all children admitted with diagnosis of tetanus between January 2009 and December 2010. A total of 140 cases of tetanus were admitted; 45 cases of neonatal tetanus (NT) and 77 cases of post-neonatal tetanus (PNT) were studied. Age of presentation of NT was 9.4 ± 1.2 days. Home-delivered children accounted for 86.7% of cases, with 77.8% being attended by untrained birth attendants. Unimmunized mothers accounted for 93.4%. In PNT, otogenic route of infection and trauma were present in 58.4% and 23.3% of cases, respectively. The rate of hospital admission of tetanus remains high. Unlike previously published reports, otogenic route is the most common mode of PNT infection in this study. Improving immunization, increasing deliveries by skilled birth attendants and prompt treatment of suppurative otitis media are the main areas in which public health initiatives need to be focused.

SURAKSHA: Early Childhood Care and Education in India. Volumes 1-8; Monograph Series No. 1-8.

ERIC Educational Resources Information Center

Swaminathan, Mina, Ed.

The Suraksha monograph series contains eight volumes which discuss innovative early childhood care and education programs in India, especially those which address the intersecting needs of women, young children, and girls. Each report in this series presents a case study of one program, highlighting its achievements, philosophy and goals,…

Skill Upgrading within Informal Training: Lessons from the Indian Auto Mechanic

ERIC Educational Resources Information Center

Barber, Jamie

2004-01-01

Informal training is known to be the dominant skill acquisition strategy for the majority of workers in India and many other economically developing countries and there is much benefit in understanding the strengths and weaknesses of this form of training. A participant observation case study was undertaken in northern India to investigate these…

Multiple Factors Supporting the Transition to ICT-Rich Learning Environments in India, Turkey, and Chile

ERIC Educational Resources Information Center

Light, Daniel

2010-01-01

This research project used instrumental case studies of successful schools from the Intel® Teach Essentials Course in Turkey, India and Chile to examine what contextual factors might facilitate teachers' ability to transfer a professional development program about ICT and innovative teaching strategies into their classrooms given the school…

Biodiversity Conservation through Environmental Education for Sustainable Development--A Case Study from Puducherry, India

ERIC Educational Resources Information Center

Ramadoss, Alexandar; Poyya Moli, Gopalsamy

2011-01-01

Promoting students commitment to protect local biodiversity is an important goal of education for sustainable development in India and elsewhere. The main focus of the biodiversity education was to create knowledge, interest and necessary skills to solve various biodiversity problems with reference to the local context. In order to develop the…

A Smart Partnership: Integrating Educational Technology for Underserved Children in India

ERIC Educational Resources Information Center

Charania, Amina; Davis, Niki

2016-01-01

This paper explores the evolution of a large multi-stakeholder partnership that has grown since 2011 to scale deep engagement with learning through technology and decrease the digital divide for thousands of underserved school children in India. Using as its basis a case study of an initiative called integrated approach to technology in education…

A Case Study on Accessibility of School in Tribal Areas and Its Implications on Educational Inclusiveness

ERIC Educational Resources Information Center

Pajankar, Vishal D.

2016-01-01

Schools accessibility has been areas of concern for the development and proliferation of the education system in any developing nation. India is no exception to the same. Since the time India gained independence efforts have been made to provide inclusiveness in the dissemination of educational facilities across the nation. However, geographical…

Powering the Women in Agriculture: Lessons on Women Led Farm Mechanisation in South India

ERIC Educational Resources Information Center

Alex, Jiju P.

2013-01-01

Purpose: This article analyses how an initiative on farm mechanisation by a local government in Kerala in South India evolved into a formal organisation that provides sustainable livelihood options to women and small and marginal farmers and revived the rice production system. Design/methodology/approach: The study followed the case analysis…

Examining Entrepreneurial Competencies and their Relationship to Self-Employment Intentions among Engineering Students: A Case Study from India

ERIC Educational Resources Information Center

Kumara, S. A. Vasantha; Kumar, Y. Vijaya

2010-01-01

The growth of technological institutions in India has been exponential and supply has exceeded demand in the job market. Against this background, it is a social responsibility of universities to provide alternative career options for engineering graduates. To encourage entrepreneurship careers among engineering graduates, the Visvesvarayya…

Can Non-Formal Education Keep Working Children in School? A Case Study from Punjab, India

ERIC Educational Resources Information Center

Sud, Pamela

2010-01-01

This paper analyses the effectiveness of non-formal schools for working children in Jalandhar, Punjab, India, in mainstreaming child labourers into the formal education system through incentivised, informal schooling. Using a family fixed effects model and sibling data as an equivalent population comparison group, I find that the non-formal…

Educating the Urban Poor: A Case Study of Running Preschools in Non-Notified Slums of India

ERIC Educational Resources Information Center

Vaijayanti, K.; Subramanian, Mathangi

2015-01-01

United Nations Children's Fund (UNICEF) recently reported that the world's population is shifting to its cities. India is no exception. Throughout the country, an increasing number of migrants are leaving agricultural lifestyles in search of economic and educational opportunities, often relocating to non-notified slums. Despite the fact that many…

Evaluation of the WHO clinical case definition of AIDS among children in India.

PubMed

Gurprit, Grover; Tripti, Pensi; Gadpayle, A K; Tanushree, Banerjee

2008-03-01

The need of a clinical case definition (CCD) for Acquired Immunodeficiency Syndrome (AIDS) was felt by public health agencies to monitor diseases resulting from human immunodeficiency virus (HIV) infection. To test the statistical significance of the existing World Health Organization (WHO) CCD for the diagnosis of AIDS in areas where diagnostic resources are limited in India, a prospective study was conducted in the Paediatrics department at Dr. Ram Manohar Lohia Hospital, New Delhi. 360 cases between 18 months-12 years of age satisfying WHO case definitions of AIDS were included in the study group. Informed consent was taken from the parents. The serum of patients was subjected to ELISA to conform the diagnosis of HIV infection. Our study detected 16.66% (60) of HIV prevalence in children visiting paediatrics outpatient clinic. 20% cases manifested 3 major and 2 minor signs. This definition had a sensitivity of 73.33%, specificity of 90.66%, positive predictive value (PPV) of 61.11% and negative predictive value (NPV) of 94.44%. On using stepwise logistic regression analysis weight loss, chronic fever > 1 month and total lymphocyte count of less than 1500 cells/mm3 emerged as important predictors. Cases showing 2 major and 2 minor signs were 86 (23.89%) with a sensitivity and specificity of 86.66% and 88.66% respectively. Based on these findings, we propose a clinical case definition based on 13 clinical signs and symptoms for paediatric AIDS in India with better sensitivity and PPV than the WHO case definition but with almost similar specificity. Thus multicentric studies are further required to modify these criteria in Indian set up.

The impact of cultural evolution on the ego ideal, depression, psychosis, and suicide: a South India community study of the widow.

PubMed

Ullrich, Helen E

2011-01-01

Cultural factors have a significant impact on the manifestation of psychiatric illness and the development of the ego ideal. The evolution of the widow's cultural role in a South India village provides insight on the ego ideal through several generations. As treatment of widows changed so that their appearance became indistinguishable from other women, they no longer became objects of revulsion. A case study approach documents the interrelationship of changes in the cultural ego ideal on psychiatric illness among widows in a South India village over a period of more than four decades.

Profile of injury cases admitted to a tertiary level hospital in south India.

PubMed

Uthkarsh, Pallavi Sarji; Suryanarayana, S P; Gautham, M S; Shivraj, N S; Murthy, N S; Pruthvish, S

2012-01-01

Injuries now rank among the leading causes of morbidity and mortality the world over. Injuries are steadily increasing in developing countries like India. Systematic and scientific efforts in injury prevention and control are yet to begin in India. Data on injuries are very essential to plan preventive and control measures. The objective of this study is to know the profile of the injury cases admitted to M S Ramaiah hospital, Bangalore, India, using a cross-sectional study design for six months, i.e. from Oct 2008 to April 2009. The mean age of the study population was 35.3 years (SD = 15.38), 69.1% were injured in road traffic accidents (RTA), 28.7% due to falls and 2.2% due to burns. Nearly 14.4% were under the influence of alcohol. Nearly 73.6% of RTA cases were two-wheeler users, 48.5% had not followed sign boards and 56.5% had not obeyed the one-way rules, 63.5% of the two-wheeler users did not use helmets. Also, 38% of two wheelers had two pillion riders, whereas 57% of four-wheeler users had not used a seat belt. Among falls, 58% occurred at home, 49% occurred due to slippery surface. Road traffic accidents were the most common cause for injuries, in which two wheelers were most commonly involved. Strict enforcement of traffic rules and education on road safety are very essential to prevent injuries.

Portrait of a science teacher as a bricoleur: A case study from India

NASA Astrophysics Data System (ADS)

Sharma, Ajay

2008-12-01

This paper presents a case study of science teaching in an eighth grade school classroom in India. It comes out of a larger ethnographic study done in 2005 that looked at how science was taught and learned in a rural government run middle school in the state of Madhya Pradesh in India. Subscribing to a sociocultural perspective, the paper presents a narrative account of how a science teacher negotiated and made use of the existing discourses that influenced his teaching practice to construct learning experiences for his students. It is a portrait of him as a bricoleur, engaged in making-do with what is of available to conform to prescriptive discursive norms as well as engage in situated, contingent and collaborative pedagogical improvisations with his students. Through a discursive analysis of Mr. Raghuvanshi's teaching practice, this paper presents his bricolage as a feature of everyday sociocultural practices, and as an instance of glocalization of decontextualized school science discourse. It also offers a case for creation and strengthening of material conditions that support enactment of teacher agency for construction of meaningful and relevant learning experiences for students. [InlineMediaObject not available: see fulltext.][InlineMediaObject not available: see fulltext.

Periorbital Dirofilariasis: A Rare Case from Western India

PubMed Central

Kulkarni, Varsha

2016-01-01

Dirofilariasis is a zoonotic disease caused commonly by Dirofilaria repens and Dirofilaria immitus. The definitive hosts are domestic dogs and cats. Human beings are accidental dead end hosts, and acquire infestation through mosquito bites. So far, very few cases have been reported from western India. We report a case of a 27-year-old male who presented with preseptal cellulitis right eye and a firm mass in the lower lid. Histopathological examination after surgical excision of the mass revealed a diagnosis of dirofilariasis. Although rare in Western India a diagnosis of dirofilariasis should be considered in cases of preseptal cellulitis associated with a periorbital mass. PMID:27134918

Periorbital Dirofilariasis: A Rare Case from Western India.

PubMed

Nagpal, Shubha; Kulkarni, Varsha

2016-03-01

Dirofilariasis is a zoonotic disease caused commonly by Dirofilaria repens and Dirofilaria immitus. The definitive hosts are domestic dogs and cats. Human beings are accidental dead end hosts, and acquire infestation through mosquito bites. So far, very few cases have been reported from western India. We report a case of a 27-year-old male who presented with preseptal cellulitis right eye and a firm mass in the lower lid. Histopathological examination after surgical excision of the mass revealed a diagnosis of dirofilariasis. Although rare in Western India a diagnosis of dirofilariasis should be considered in cases of preseptal cellulitis associated with a periorbital mass.

Human brucellosis among pyrexia of unknown origin cases and occupationally exposed individuals in Goa Region, India.

PubMed

Pathak, Ajay D; Dubal, Zunjar B; Doijad, Swapnil; Raorane, Abhay; Rodrigues, Savio; Naik, Rajeshwar; Naik-Gaonkar, Shraddha; Kalorey, Dewanand R; Kurkure, Nitin V; Naik, Rajesh; Barbuddhe, Sukhadeo B

2014-01-01

Brucellosis is a widespread zoonotic infection. This disease is endemic in many parts of Asia, including India. Brucellosis is a major cause of pyrexia of unknown origin (PUO). Persons exposed to infected animals or contaminated animal products are at high risk. Seropositivity among animal handlers, veterinarians and dairy workers has been documented in India. Thus, the present study was aimed to determine prevalence of brucellosis among PUO cases and occupationally exposed individuals. In this study, serum samples (n=282) from cases of pyrexia of unknown origin (PUO) (n=243), and occupationally exposed individuals (n=39) were collected and tested for brucellosis by Rose Bengal plate test (RBPT), serum agglutination test (SAT), indirect ELISA, IgG and IgM ELISA. Blood culture for isolation of Brucella was performed for 10 serologically positive patients using BACTEC 9050 automated blood culture system. Biochemical tests and PCR techniques were used for confirmation of the isolates. Of the samples tested, 4.25%, 3.54%, 6.02% and 4.96% samples were positive by RBPT, SAT, indirect ELISA and IgG ELISA, respectively. None of the sample was positive for IgM ELISA. Of the 10 blood samples cultured bacteriologically, one Brucella isolate was recovered. The isolate was confirmed as Brucella abortus. Amplification of the bcsp31 and IS711 genes was also observed. Seropositivity for brucellosis was observed among PUO cases, animal handlers and dairy workers in Goa, India. The serological tests showed variable results. One Brucella isolate was obtained by performing blood culture. Confirmation of the case was done rapidly using molecular tools. General awareness about clinical symptoms should be increased which will improve proper diagnosis within short time frame.

Characterization of hepatitis E virus from sporadic hepatitis cases and sewage samples from Vellore, south India

PubMed Central

Vivek, Rosario; Zachariah, Uday G.; Ramachandran, Jeyamani; Eapen, Chundamannil E.; Rajan, Deva P.; Kang, Gagandeep

2017-01-01

Background Hepatitis E virus (HEV) is endemic in India and causes epidemics and sporadic cases. However, the exact transmission route for sporadic hepatitis E remains unclear. This study investigated HEV in sporadic hepatitis cases and sewage samples, as sewage is the major source of contamination of water in developing countries. Methods Monthly sampling and testing for HEV in sewage samples from Vellore, India was carried out for 1 year (November 2009–October 2010) and plasma and/or fecal samples from sporadic hepatitis cases presenting to a hospital in Vellore during 2006–2010 were tested for HEV RNA. A total of 144 raw sewage samples and 94 samples from sporadic hepatitis cases were tested for HEV RNA using RT-PCR. Results The prevalence of HEV RNA in sewage and sporadic cases was 55.6% and 9.6%, respectively. HEV strains isolated from sewage showed 94–100% nucleotide sequence similarity with the HEV strains isolated from the sporadic hepatitis cases. HEV RNA in sewage was identified more often during the summer (81.2%) than the monsoon season (14.5%) (p < 0.001). Conclusion This study indicates that sewage may be a source of contamination for sporadic hepatitis and also underscores the need for preventive measures to protect drinking water from sewage contamination, particularly in the summer. GenBank accession numbers HEV strains isolated from this study were deposited in GenBank under accession numbers JF972766–JF972773, JN705651–JN705659 and JN705660–JN705662. PMID:23677583

Vocational Training in India and the Duality Principle: A Case for Evidence-Based Reform

ERIC Educational Resources Information Center

Mehrotra, Santosh; Kalaiyarasan, A.; Kumra, Neha; Ravi Raman, K.

2015-01-01

This article explores the notion of the duality principle, as embodied in the German dual system of Vocational Education and Training (VET), within the context of a field survey of skill shortages faced by German and Indian firms operating in India. The study finds that these firms experience problems with the quantity and quality of skills…

Towards Inclusive Education: A Case Study of IGNOU

ERIC Educational Resources Information Center

Chaudhury, S. V. S.; Khare, Pankaj; Gupta, Sanjay; Garg, Suresh

2016-01-01

Towards the end of the Eleventh Five Year Plan (2007 -2012), India catered to about 20 per cent of those in the age group 17 to 24 years. However, to achieve the threshold level of about 30 per cent by 2020, and address concerns that perpetuate inequalities in opportunities to higher education, the Government of India (GoI) formulated positive…

Translation Practices as an Effective Teaching Instrument for IELTS & DALF Students in India: A Case Study

ERIC Educational Resources Information Center

Verma, E. S.

2016-01-01

The article outlines the results of using translation as a tool to help students learn English and French in the multicultural environment of Chandigarh, India. An anonymous group of eight students was observed from 2013 until 2015 to reveal the main concepts of the use of translation in helping Indian students to strengthen their language…

The Role of Parents in the Education of Children of Pre-School Age in Tropical Africa, India and the Maghreb Countries.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France). Div. of Structures, Content, Methods and Techniques of Education.

The case studies summarized in this report are based on ethnographic surveys carried out mainly in Cameroon, the Central African Republic, Ivory Coast, and Senegal (collectively called "Tropical Africa" in the text). The surveys were also carried out in the Maghreb countries, especially Algeria and southern India. Their common objective…

Integrating the Poor through e-Governance: A Case Study of the National e-Governance Plan in India

ERIC Educational Resources Information Center

Dasgupta, Shib Shankar

2010-01-01

This dissertation examines the adoption and implementation mechanism of the national e-Governance plan in the regional state of West Bengal in India. The questions that this dissertation seek to illuminate are (i) the various potentials and challenges in integrating the ordinary citizens in the implementation of the national e-Governance plan in…

Identifying Structural Changes from Within: Emancipatory Narratives Exploring Community Constraints to Women's Education and Empowerment in Rural India

ERIC Educational Resources Information Center

Baily, Supriya

2015-01-01

Using a critical theory framework, the article explores emancipatory narratives obtained through a case study of women in rural India. In-depth interviews, focus group conversations, observations, and document analysis highlight the complexity of the subsequent set of challenges facing women as it relates to both the education and empowerment for…

A Global Approach to School Education and Local Reality: A Case Study of Community Participation in Haryana, India

ERIC Educational Resources Information Center

Narwana, Kamlesh

2015-01-01

In post-Jomtien phase, community participation in school education management has appeared as one of the most prominent features in all educational development programmes at global level. In line with this trend, India has also placed a significant focus on local communities in school management through various programmes such as LokJumbish,…

Association of Malassezia species with dandruff.

PubMed

Rudramurthy, Shivaprakash M; Honnavar, Prasanna; Dogra, Sunil; Yegneswaran, Prakash P; Handa, Sanjeev; Chakrabarti, Arunaloke

2014-03-01

Malassezia species implicated with dandruff vary at different geographical locations. The present study was conducted to determine the spectrum and distribution of Malassezia species in dandruff patients and healthy individuals. Patients with dandruff from northern (Chandigarh) and southern (Manipal, Karnataka) parts of India (50 each) and healthy individuals (20) were included in the study. Dandruff severity was graded as mild, moderate and severe. Malassezia spp. isolated were quantified and identified by phenotypic characters and molecular methods including PCR-RFLP and DNA sequencing. Number of Malassezia spp. retrieved was significantly higher (P<0.001) in dandruff cases (84%) as compared to healthy individuals (30%). Isolation of Malassezia spp. was significantly higher (P<0.01) in patients from southern India. In moderately severe cases M. restricta was single most predominant (37.8%) isolate from patients of northern part of India and M. furfur (46.4%) from patients of southern part of India. Malassezia density was significantly associated with the severity of dandruff (P<0.001). Our results on a limited number of individuals show that Malassezia spp. associated with dandruff varies in different regions of the country and the density of yeasts increases with severity of disease.

Association of Malassezia species with dandruff

PubMed Central

Rudramurthy, Shivaprakash M.; Honnavar, Prasanna; Dogra, Sunil; Yegneswaran, Prakash P.; Handa, Sanjeev; Chakrabarti, Arunaloke

2014-01-01

Background & objectives: Malassezia species implicated with dandruff vary at different geographical locations. The present study was conducted to determine the spectrum and distribution of Malassezia species in dandruff patients and healthy individuals. Methods: Patients with dandruff from northern (Chandigarh) and southern (Manipal, Karnataka) parts of India (50 each) and healthy individuals (20) were included in the study. Dandruff severity was graded as mild, moderate and severe. Malassezia spp. isolated were quantified and identified by phenotypic characters and molecular methods including PCR-RFLP and DNA sequencing. Results: Number of Malassezia spp. retrieved was significantly higher (P<0.001) in dandruff cases (84%) as compared to healthy individuals (30%). Isolation of Malassezia spp. was significantly higher (P<0.01) in patients from southern India. In moderately severe cases M. restricta was single most predominant (37.8%) isolate from patients of northern part of India and M. furfur (46.4%) from patients of southern part of India. Malassezia density was significantly associated with the severity of dandruff (P<0.001). Interpretation & conclusions: Our results on a limited number of individuals show that Malassezia spp. associated with dandruff varies in different regions of the country and the density of yeasts increases with severity of disease. PMID:24820838

Dengue burden in India: recent trends and importance of climatic parameters.

PubMed

Mutheneni, Srinivasa Rao; Morse, Andrew P; Caminade, Cyril; Upadhyayula, Suryanaryana Murty

2017-08-09

For the past ten years, the number of dengue cases has gradually increased in India. Dengue is driven by complex interactions among host, vector and virus that are influenced by climatic factors. In the present study, we focused on the extrinsic incubation period (EIP) and its variability in different climatic zones of India. The EIP was calculated by using daily and monthly mean temperatures for the states of Punjab, Haryana, Gujarat, Rajasthan and Kerala. Among the studied states, a faster/low EIP in Kerala (8-15 days at 30.8 and 23.4 °C) and a generally slower/high EIP in Punjab (5.6-96.5 days at 35 and 0 °C) were simulated with daily temperatures. EIPs were calculated for different seasons, and Kerala showed the lowest EIP during the monsoon period. In addition, a significant association between dengue cases and precipitation was also observed. The results suggest that temperature is important in virus development in different climatic regions and may be useful in understanding spatio-temporal variations in dengue risk. Climate-based disease forecasting models in India should be refined and tailored for different climatic zones, instead of use of a standard model.

Dengue burden in India: recent trends and importance of climatic parameters

PubMed Central

Mutheneni, Srinivasa Rao; Morse, Andrew P; Caminade, Cyril; Upadhyayula, Suryanaryana Murty

2017-01-01

For the past ten years, the number of dengue cases has gradually increased in India. Dengue is driven by complex interactions among host, vector and virus that are influenced by climatic factors. In the present study, we focused on the extrinsic incubation period (EIP) and its variability in different climatic zones of India. The EIP was calculated by using daily and monthly mean temperatures for the states of Punjab, Haryana, Gujarat, Rajasthan and Kerala. Among the studied states, a faster/low EIP in Kerala (8–15 days at 30.8 and 23.4 °C) and a generally slower/high EIP in Punjab (5.6–96.5 days at 35 and 0 °C) were simulated with daily temperatures. EIPs were calculated for different seasons, and Kerala showed the lowest EIP during the monsoon period. In addition, a significant association between dengue cases and precipitation was also observed. The results suggest that temperature is important in virus development in different climatic regions and may be useful in understanding spatio-temporal variations in dengue risk. Climate-based disease forecasting models in India should be refined and tailored for different climatic zones, instead of use of a standard model. PMID:28790459

A Family Study of Consanguinity in Children with Intellectual Disabilities in Barwani, India.

PubMed

Lakhan, Ram; Bipeta, Rajshekhar; Yerramilli, Srinivasa S R R; Nahar, Vinayak K

2017-01-01

Intellectual disability (ID) can be inherited in families through consanguineous marriage. The ID in an individual can be associated with the ID, epilepsy, and mental illness in their parents. Such connections can be seen more closely among consanguineous marriages in tribal and nontribal population in India. This study shows a few common patterns of the consanguineous relationship in the parents of children with ID in India. This is a case series research design. Extreme or deviant case sampling was applied. Data were collected in homes, camps, and clinical settings in the Barwani district of Madhya Pradesh, India. The patterns of consanguineous marriages and the relationship between children with ID and their relatives with ID, epilepsy, and mental illness were analyzed and reported with pedigree charts. Multiple patterns of consanguineous marriages in tribal and nontribal populations were observed. ID was found to be associated in children with their relatives of the first, second, and third generations. ID may inherit in individuals from their relatives of the first, second, and third generations who have ID, epilepsy, or mental illness and married in the relationship. Appropriate knowledge, guidance, and counseling may be provided to potential couples before planning a consanguineous marriage.

Characteristics of suicidal attempts among farmers in rural South India

PubMed Central

Kumar, Ravi S.; Hashim, Uzma

2017-01-01

Background: Globally, farming as an industry is considered a high-risk occupation for suicides. Certain states in India like Karnataka have a suicide rate higher than the national average, and this is generally attributed to the farmers’ suicide. Aims: The aim is to study the characteristics of suicidal attempts among the farmer community in South India, with special emphasis on gender differences, modes used, and the immediate precipitant causes. Materials and Methods: Retrospective, case register-based, explorative-descriptive study of 426 consecutive medicolegal case files of patients whose stated occupation was farming and who were admitted as cases of deliberate self-harm or suicide attempt to a rural tertiary care hospital in rural South India. Results: Out of the 426 farmers who attempted suicide, majority were male (355, 83.3%), in the age group of 21–40 years (318, 75%), married (358, 84%), and belonging to lower socioeconomic status (268, 62.9%). About 54% of them had attempted suicide by consuming pesticides (230). Surprisingly, 183 (43%) and 86 (20.2%) reported the immediate precipitant as being relationship issues and marital conflict, respectively, and only 100 (23.5%) attributed it to financial reasons. Females were significantly associated with a past history of suicidal attempt while males tended to abuse alcohol before an attempt more frequently. Conclusions: Pesticide poisoning was the most common mode for attempting suicide among the farmers. Contrary to public perception and other studies, relationship, and marital issues, not financial reasons were found to be the most common immediate precipitant for the attempters in our study. PMID:29456318

Voices of decision makers on evidence-based policy: A case of evolving TB/HIV co-infection policy in India.

PubMed

Reddy, K Srikanth; Sahay, Seema

2016-01-01

This study explores decision makers' perspectives on evidence-based policy (EBP) development using the case of TB/HIV co-infection in India. Twelve in-depth interviews were conducted with purposively selected key national and international policy decision makers in India. Verbatim transcripts were processed and analysed thematically using QSR (NUD*IST 6). The decision makers were unequivocal in recognizing the TB/HIV co-infection as an important public health issue in India and stated the problem to be different than Africa. The need of having a "third programme" for co-infection was not felt. According to them, the public health management of this co-infection must be within the realm of these two programmes. The study also emphasized on decision makers' perspectives on evidence and the process of utilization of evidence for decision-making for co-infection. Study findings showed global evidence was not always accepted by the decision makers and study shows several examples of decision makers demanding local evidence for policy decisions. Decision makers did make interim policies based on global evidence but most of the time their mandate was to get local evidence. Thus, operations research/implementation science especially multi-centric studies emerge as important strategy for EBP development. Researcher-policy maker interface was a gap where role of researcher as aggressive communicator of research findings was expected.

Cost-effectiveness of community screening for glaucoma in rural India: a decision analytical model.

PubMed

John, D; Parikh, R

2018-02-01

Studies in several countries have demonstrated the cost-effectiveness of population-based screening for glaucoma when targeted at high-risk groups such as older adults and with familial history of disease. This study conducts a cost-effective analysis of a hypothetical community screening and subsequent treatment programme in comparison to opportunistic case finding for glaucoma in rural India. A hypothetical screening programme for both primary open-angle glaucoma and angle-closure disease was built for a population aged between 40 and 69 years in rural areas of India. A decision analytical model was built to model events, costs and treatment pathways with and without a hypothetical screening programme for glaucoma for a rural-based population aged between 40 and 69 years in India. The treatment pathway included both primary open-angle glaucoma and angle-closure disease. The data on costs of screening and treatment were provided by an administrator of a tertiary eye hospital in Eastern India. The probabilities for the screening and treatment pathway were derived from published literature and a glaucoma specialist. The glaucoma prevalence rates were adapted from the Chennai Glaucoma Study findings. An incremental cost-effectiveness ratio value of ₹7292.30 per quality-adjusted life-year was calculated for a community-screening programme for glaucoma in rural India. The community screening for glaucoma would treat an additional 2872 cases and prevent 2190 person-years of blindness over a 10-year period. Community screening for glaucoma in rural India appears to be cost-effective when judged by a ratio of willingness-to-pay thresholds as per WHO-CHOICE guidelines. For community screening to be cost-effective, adequate resources, such as trained medical personnel and equipment would need to be made available. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Prevalence of food sensitization and probable food allergy among adults in India: the EuroPrevall INCO study.

PubMed

Mahesh, P A; Wong, Gary W K; Ogorodova, L; Potts, J; Leung, T F; Fedorova, O; Holla, Amrutha D; Fernandez-Rivas, M; Clare Mills, E N; Kummeling, I; Versteeg, S A; van Ree, R; Yazdanbakhsh, M; Burney, P

2016-07-01

Data are lacking regarding the prevalence of food sensitization and probable food allergy among general population in India. We report the prevalence of sensitization and probable food allergy to 24 common foods among adults from general population in Karnataka, South India. The study was conducted in two stages: a screening study and a case-control study. A total of 11 791 adults in age group 20-54 were randomly sampled from general population in South India and answered a screening questionnaire. A total of 588 subjects (236 cases and 352 controls) participated in the case-control study involving a detailed questionnaire and specific IgE estimation for 24 common foods. A high level of sensitization (26.5%) was observed for most of the foods in the general population, higher than that observed among adults in Europe, except for those foods that cross-react with birch pollen. Most of the sensitization was observed in subjects who had total IgE above the median IgE level. A high level of cross-reactivity was observed among different pollens and foods and among foods. The prevalence of probable food allergy (self-reports of adverse symptoms after the consumption of food and specific IgE to the same food) was 1.2%, which was mainly accounted for cow's milk (0.5%) and apple (0.5%). Very high levels of sensitization were observed for most foods, including those not commonly consumed in the general population. For the levels of sensitization, the prevalence of probable food allergy was low. This disassociation needs to be further explored in future studies. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Potential for early warning of maalria in India using NOAA-AVHRR based vegetation health indices

NASA Astrophysics Data System (ADS)

Dhiman, R. C.; Kogan, Felix; Singh, Neeru; Singh, R. P.; Dash, A. P.

Malaria is still a major public health problem in India with about 1 82 million cases annually and 1000 deaths As per World Health Organization WHO estimates about 1 3 million Disability Adjusted Life Years DALYs are lost annually due to malaria in India Central peninsular region of India is prone to malaria outbreaks Meteorological parameters changes in ecological conditions development of resistance in mosquito vectors development of resistance in Plasmodium falciparum parasite and lack of surveillance are the likely reasons of outbreaks Based on satellite data and climatic factors efforts have been made to develop Early Warning System EWS in Africa but there is no headway in this regard in India In order to find out the potential of NOAA satellite AVHRR derived Vegetation Condition Index VCI Temperature Condition Index TCI and a cumulative indicator Vegetation Health Index VHI were attempted to find out their potential for development of EWS Studies were initiated by analysing epidemiological data of malaria vis-a-vis VCI TCI and VHI from Bikaner and Jaisalmer districts of Rajasthan and Tumkur and Raichur districts of Karnataka Correlation coefficients between VCI and monthly malaria cases for epidemic years were computed Positive correlation 0 67 has been found with one-month lag between VCI and malaria incidence in respect of Tumkur while a negative correlation with TCI -0 45 is observed In Bikaner VCI is found to be negatively related -0 71 with malaria cases in epidemic year of 1994 Weekly

Analysis of different types of poisoning in a tertiary care hospital in rural South India.

PubMed

Jaiprakash, Heethal; Sarala, N; Venkatarathnamma, P N; Kumar, T N

2011-01-01

The global problem of acute poisoning has steadily increased over the past few years. It is an important cause of morbidity and mortality in developing countries. Better preventive and management strategies can be developed if the incidence and pattern of acute poisoning is known. The study aims at analyzing the pattern, cause and mortality rate of poisoning. The study was conducted in a rural area in South India. This retrospective study was conducted from January 2003-December 2003. The data was analysed using descriptive statistics. Out of the 225 cases 139 were males and 86 females. Poisoning was common in the age group of 21-30 years which was 84 cases and 11-20 years was 73 cases. The poisons consumed were as follows: Organophosphorous 135 cases, aluminum and zinc phosphide 50 cases, phenobarbitone 18 cases, benzodiazepines 7 cases, paracetamol 2 cases, miscellaneous 13 cases. 94% were suicides and 6% accidental. Mortality rate was 12.8%. Establishment of strict policies against the sale and availability of pesticides and over the counter drugs is an effective way to control organophosphorous and drug poisoning. Copyright © 2010 Elsevier Ltd. All rights reserved.

Operational Efficiency of an Immunization Clinic Attached to Rural Health Training Centre in Delhi, India: A Time and Motion Study

PubMed Central

Kumar, Varun; Mangal, Abha; Panesar, Sanjeet; Yadav, Geeta; Talwar, Richa; Raut, Deepak; Singh, Saudan

2014-01-01

Background. Obtaining baseline data about current patterns of work is important for assessing the effects of interventions designed to improve care delivery. Time and motion studies allow for the most accurate measurement of structured components. Therefore, the present study was conducted to study the operational efficiency of an immunization clinic in Delhi, India. Methods. An observational cross-sectional study was conducted at the immunization clinic of Rural Health Training Centre in Delhi, India, from January 2014 to March 2014. The study composed two stage evaluations, a passive observation and a time and motion study. Systemic random sampling method was used to select 863 mothers/caregivers attending the immunization clinic. Results. At the immunization clinic, the study participants spent 64.1% of their total time in waiting. For new cases, the mean time taken for initial registration and receiving postvaccination advice was found to be significantly longer than old cases. Delivering health care services took more time during Mondays and also during the first hour of the day. Conclusion. Results of this study will guide public health decision-makers at all government levels in planning and implementation of immunization programs in developing countries. PMID:25431679

Group C rotavirus infection in patients with acute gastroenteritis in outbreaks in western India between 2006 and 2014.

PubMed

Joshi, M S; Jare, V M; Gopalkrishna, V

2017-01-01

Faecal specimens collected from outbreak (n = 253) and sporadic (n = 147) cases of acute gastroenteritis that occurred in western India between 2006 and 2014 were tested for group C rotavirus (GCR) using partial VP6 gene-based RT-PCR. All specimens were tested previously for the presence of other viral and bacterial aetiological agents by conventional methods. The rate of GCR detection was 8·6% and 0·7% in outbreak and sporadic cases, respectively. GCR infections prevailed in outbreaks reported from rural areas (10·9%) compared to urban areas (1·6%). Clinical severity score of the patients with GCR infection (n = 23) indicated severe disease in the majority (70%) of cases. The age distribution analysis indicated 52·1% of GCR infections in children aged <10 years. The male:female ratio in GCR-positive patients was 2·3:1. Of the 23 GCR-positive cases, 17 (73·9%) had a sole GCR infection and six had mixed infections with other viral and/or bacterial agents. Phylogenetic analysis of nucleotide sequences classified GCR strains of the study in to I2 genotype of the VP6 gene. This is the first study to show the occurrence of GCR in gastroenteritis outbreaks in India.

Forecasting malaria cases using climatic factors in delhi, India: a time series analysis.

PubMed

Kumar, Varun; Mangal, Abha; Panesar, Sanjeet; Yadav, Geeta; Talwar, Richa; Raut, Deepak; Singh, Saudan

2014-01-01

Background. Malaria still remains a public health problem in developing countries and changing environmental and climatic factors pose the biggest challenge in fighting against the scourge of malaria. Therefore, the study was designed to forecast malaria cases using climatic factors as predictors in Delhi, India. Methods. The total number of monthly cases of malaria slide positives occurring from January 2006 to December 2013 was taken from the register maintained at the malaria clinic at Rural Health Training Centre (RHTC), Najafgarh, Delhi. Climatic data of monthly mean rainfall, relative humidity, and mean maximum temperature were taken from Regional Meteorological Centre, Delhi. Expert modeler of SPSS ver. 21 was used for analyzing the time series data. Results. Autoregressive integrated moving average, ARIMA (0,1,1) (0,1,0)(12), was the best fit model and it could explain 72.5% variability in the time series data. Rainfall (P value = 0.004) and relative humidity (P value = 0.001) were found to be significant predictors for malaria transmission in the study area. Seasonal adjusted factor (SAF) for malaria cases shows peak during the months of August and September. Conclusion. ARIMA models of time series analysis is a simple and reliable tool for producing reliable forecasts for malaria in Delhi, India.

Contact screening and chemoprophylaxis in India's Revised Tuberculosis Control Programme: a situational analysis.

PubMed

Banu Rekha, V V; Jagarajamma, K; Wares, F; Chandrasekaran, V; Swaminathan, S

2009-12-01

India's Revised National Tuberculosis Control Programme (RNTCP) recommends screening of all household contacts of smear-positive pulmonary tuberculosis (PTB) cases for tuberculosis (TB) disease, and 6-month isoniazid preventive therapy (IPT) for asymptomatic children aged <6 years. To assess the implementation of child contact screening and IPT administration under the RNTCP. A cross-sectional study conducted in four randomly selected TB units (TUs), two in an urban (Chennai City) and two in a rural (Vellore District) area of Tamil Nadu, South India, from July to September 2008. The study involved the perusal of TB treatment cards of source cases (new or retreatment smear-positive PTB patients started on treatment), interview of source cases and focus group discussions (FGDs) among health care workers. Interviews of 253 PTB patients revealed that of 220 contacts aged <14 years, only 31 (14%) had been screened for TB, and that of 84 household children aged <6 years, only 16 (19%) had been initiated on IPT. The treatment cards of source cases lacked documentation of contact details. FGDs revealed greater TB awareness among urban health care workers, but a lack of detailed knowledge about procedures. Provision for documentation using a separate IPT card and focused training may help improve the implementation of contact screening and IPT.

Loss of heterozygosity at 11p13 and 11p15 in Wilms tumor: a study of 22 cases from India.

PubMed

Sigamani, Elanthenral; Wari, Mohammad Nahidul; Iyer, Venkateswaran K; Agarwala, Sandeep; Sharma, Arundhati; Bakhshi, Sameer; Dinda, Amit

2013-03-01

11p13 and 11p15 loss of heterozygosity (LOH) in Wilms tumor (WT), the commonest molecular pathogenetic event in WT, shows variation in different parts of the world. The present study looked for the presence of 11p13 and 11p15 LOH as well as nephrogenic rests in WT occurring in India. Twenty-two cases of WT were subjected to thorough pathological examination for presence of nephrogenic rests. Fresh frozen tissue was evaluated for LOH at 11p13 and 11p15, using PCR for microsatellite markers. Among twenty-two consecutive cases of WT, 20 were unilateral and 2 were bilateral. 6/22 showed LOH at 11p13 (27.7 %) and 1/22 showed LOH at 11p15 (4.54 %). 2/22 cases showed presence of nephrogenic rests. One of the cases with LOH at 11p13 had intralobar nephrogenic rest in the adjacent kidney. One specimen had perilobar nephrogenic rest in the adjacent kidney but did not show LOH for either 11p13 or 11p15 in the tumor. LOH at 11p13 is seen in 27.27 % of WT in India, which is similar to reports in the English language literature. LOH at 11p15 was seen in 4.54 % of WT, which is lower than that reported from Western subjects.

Human Capital, HRD and VET: The Case of India

ERIC Educational Resources Information Center

Tomé, Eduardo; Goyal, Apoorva

2015-01-01

Purpose: This paper aims to analyze the role of human capital (HC), human resource development (HRD) and vocational educational and training (VET) in the emerging Indian economy. How may we define the HC, HRD and VET in India? To what extent and how as HRD investments in India contributed to India's recent economic development? What were the…

AIDS in India.

PubMed

Shreedhar, J

1995-01-01

A major HIV epidemic is underway in India, home to 900 million people and the world's second largest population. The director-general of the Indian Council of Medical Research expects India by the year 2000 to be the country with the largest number of HIV infections, with some experts predicting 5 million people to be infected with HIV in India by the year 2000. Others predict 30-55 million to be infected. Although HIV is increasingly spreading to typically low-risk group populations, it is the female sex workers and their clients, long distance truck drivers, men who have sex with men, blood transfusion donors and recipients, and IV drug users throughout the country who are both the reservoirs of HIV and vectors of transmission to the general population. For example, 52% of sex workers in Bombay in 1994 were found to be infected with HIV. Studies indicate that India's long-distance truck drivers average 200 sexual encounters per year; at any given time, 70% of them have STDs. Preliminary surveys estimate that almost 33% are infected with HIV. HIV seroprevalence among truckers in Madras requesting HIV testing because they have STDs increased from almost 60% in 1993 to 91% in 1995. Moreover, the illegal status of homosexuality in India has created an underground culture in which HIV and STDs are rampant; one 1995 study in the Sangli district of Maharashtra found 50% of men who have sex with men to be infected with HIV. Half of India's blood for transfusion is drawn from commercial donors. A Bombay study, however, found 86% of such donors screened in 1992 to be HIV-seropositive and not all blood banks comply with mandatory screening laws. As widespread HIV infection evolves into a multitude of AIDS cases, India's health care system and economy will be heavily taxed, and the number of tuberculosis (TB) cases greatly increased. More than half the population carries the TB bacillus. The government by 1992 had drafted a national prevention and control plan and formed the National AIDS Control Organization (NACO), but much remains to be accomplished in the prevention and control of HIV/AIDS. Nongovernmental organizations are working to strengthen government efforts.

Injury pattern among non-fatal road traffic accident cases: a cross-sectional study in Central India.

PubMed

Ganveer, Gunjan B; Tiwari, Rajnarayan R

2005-01-01

What is the pattern of injuries among non-fatal cases of road traffic accidents? To study the pattern of injuries among non-fatal cases of road traffic accidents. Cross-sectional study. Nagpur, a city in central India. 423 non-fatal cases of road traffic accidents reporting for treatment to Indira Gandhi Medical College, Nagpur during 1999-2000. Demographic characteristics, accident characteristics. Percentages, proportions, Chi-square test. Out of total 423 subjects, 363 (85.8%) were male while only 60 (14.2%) were female subjects. Majority of the victims (75%) were in the age group 18- 37 years. Sideways collision was the most common type of accident seen in 269 (63.59%) cases. Two wheelers and LMV were the common vehicle being involved in accidents (69.97%) and these accidents were almost equally distributed in both half of the day. Fracture of the bones was the common injury afflicted to the victims followed by multiple injuries like blunt injury, abrasions and lacerations. Lower extremity was involved in 192 (45.39%) cases while multiple sites were affected in 114 (26.95%) cases. In the present study, the fractures were the commonest injury among the victims of non-fatal road traffic accidents.

Agency perspectives on transition to participatory forest management: a case study from Tamil Nadu, India

Treesearch

Jagannadha Matta; Janaki Alavalapati; John Kerr; Evan Mercer

2005-01-01

India’s Joint Forest Management (JFM) policy, in which government forest agencies and local communities jointly manage forests, has been touted as a successful strategy in helping both forests and people. Its efficacy in the field, however, is uneven. Although government forest departments are charged with implementing JFM, very little is known about their perspectives...

Entrepreneurship Education at Indian Industrial Training Institutes--A Case Study of the Prescribed, Adopted and Enacted Curriculum in and around Bangalore

ERIC Educational Resources Information Center

Zenner, Lea; Kumar, Kothandaraman; Pilz, Matthias

2017-01-01

On the one hand, India is a growing economy that needs skilled labour, self-employed entrepreneurs and employees to tackle its economic and social challenges. On the other hand, India faces high unemployment rates, especially among young people. Graduates from industrial training institutes (ITIs) in particular are often facing difficulties in…

Trust and trust relations from the providers' perspective: the case of the healthcare system in India.

PubMed

Kane, Sumit; Calnan, Michael; Radkar, Anjali

2015-01-01

Commentators suggest that there is an erosion of trust in the relations between different actors in the health system in India. This paper presents the results of an exploratory study of the situation of providers in an urban setting in western India, the nature of their relations in terms of trust and what influences these relations. The data on relationships of trust were collected through interviews and focus group discussions with key informants, including public and private providers, regulators, managers and societal actors, such as patients/citizens, politicians and the media.

Intraocular gnathostomiasis: report of a case and review of literature.

PubMed

Pillai, Gopal S; Kumar, Anil; Radhakrishnan, Natasha; Maniyelil, Jayasree; Shafi, Tufela; Dinesh, Kavitha R; Karim, Shamsul

2012-04-01

Intraocular gnathostomiasis is a rare parasitic infection caused by the third-stage larvae of spiruroid nematode Gnanthostoma spp. seen mostly in tropical and subtropical regions. It is a food-borne zoonosis caused by ingestion of raw or undercooked freshwater fish, amphibians, reptiles, birds, and mammals, all of which are known to harbor advanced third-stage larvae of Gnanthostoma spp. To date, 74 cases of intraocular gnathostomiasis have been reported from 12 different countries. Only four countries have reported more than 10 cases each, and India shares the rare distinction of being one of them, with 14 cases. Surprisingly, not a single case of cutaneous gnanthostomiasis has ever been reported from India. We present one such case of intraocular gnathostomiasis in a 41-year-old male who presented with an actively motile worm attached to the iris, and we review the pertinent literature of all such cases reported from India.

Poppies for medicine in Afghanistan: lessons from India and Turkey.

PubMed

Windle, James

2011-01-01

This study examines India and Turkey as case studies relevant to the Senlis Council’s ‘poppies for medicine’ proposal. The proposal is that Afghan farmers are licensed to produce opium for medical and scientific purposes. Here it is posited that the Senlis proposal neglects at least three key lessons from the Turkish and Indian experiences. First, not enough weight has been given to diversion from licit markets, as experienced in India. Second, both India and Turkey had significantly more efficient state institutions with authority over the licensed growing areas. Third, the proposal appears to overlook the fact that Turkey’s successful transition was largely due to the use of the poppy straw method of opium production. It is concluded that, while innovative and creative policy proposals such as that of the Senlis proposal are required if Afghanistan is to move beyond its present problems, ‘poppies for medicine’ does not withstand evidence-based scrutiny.

Patterns of Plasmodium vivax and Plasmodium falciparum malaria underscore importance of data collection from private health care facilities in India.

PubMed

Gupta, Sangeeta; Gunter, James T; Novak, Robert J; Regens, James L

2009-10-12

This study describes patterns of falciparum and vivax malaria in a private comprehensive-care, multi-specialty hospital in New Delhi from July 2006 to July 2008. Malarial morbidity by Plasmodium species (Plasmodium falciparum, Plasmodium vivax, or Plasmodium sp.) was confirmed using microscopy and antigen tests. The influence of seasonal factors and selected patient demographics on morbidity was evaluated. The proportions of malaria cases caused by P. falciparum at the private facility were compared to data from India's National Vector Borne Disease Control Programme (NVBDCP) during the same period for the Delhi region. In New Delhi, P. faciparum was the dominant cause of cases requiring treatment in the private hospital during the period examined. The national data reported a smaller proportion of malaria cases caused by P. falciparum in the national capital region than was observed in a private facility within the region. Plasmodium vivax also caused a large proportion of the cases presenting clinically at the private hospital during the summer and monsoon seasons. The proportion of P. falciparum malaria cases tends to be greatest during the post-monsoon season while the proportion of P. vivax malaria cases tends to be greatest in the monsoon season. Private hospital data demonstrate an under-reporting of malaria case incidences in the data from India's national surveillance programme during the same period for the national capital region.

Key Findings from the U.S.-India Partnership for Climate Resilience Workshop on Development and Application of Downscaling Climate Projections

NASA Astrophysics Data System (ADS)

Kunkel, K.; Dissen, J.; Easterling, D. R.; Kulkarni, A.; Akhtar, F. H.; Hayhoe, K.; Stoner, A. M. K.; Swaminathan, R.; Thrasher, B. L.

2017-12-01

s part of the Department of State U.S.-India Partnership for Climate Resilience (PCR), scientists from NOAA NCEI, CICS-NC, Texas Tech University (TTU), Stanford University (SU), and the Indian Institute of Tropical Meteorology (IITM) held a workshop at IITM in Pune, India during 7-9 March 2017 on the development, techniques and applications of downscaled climate projections. Workshop participants from TTU, SU, and IITM presented state-of-the-art climate downscaling techniques using the ARRM method, NASA NEX climate products, CORDEX-South Asia and analysis tools for resilience planning and sustainable development. PCR collaborators in attendance included Indian practitioners, researchers and other NGO including the WRI Partnership for Resilience and Preparedness (PREP), The Energy and Resources Institute (TERI), and NIH. The scientific techniques were provided to workshop participants in a software package written in R by TTU scientists and several sessions were devoted to hands-on experience with the software package. The workshop further examined case studies on the use of downscaled climate data for decision making in a range of sectors, including human health, agriculture, and water resources management as well as to inform the development of the India State Action Plans. This talk will discuss key outcomes including information needs for downscaling climate projections, importance of QA/QC of the data, key findings from select case studies, and the importance of collaborations and partnerships to apply downscaling projections to help inform the development of the India State Action Plans.

A Clinicopathological Study of Pemphigus in Eastern India with Special Reference to Direct Immunofluorescence

PubMed Central

Chowdhury, Joyeeta; Datta, Pijush Kanti; Chowdhury, Satyendra Nath; Das, Nilay Kanti

2016-01-01

Background: Pemphigus is a group of chronic autoimmune vesico-bullous disorders in which the epidermis and the basement membrane zone are the focus of attack resulting in cutaneous and mucosal blister formation. Direct immunofluorescence (DIF) test is a very sensitive test for the diagnosis Aim: To study the clinico histopathological patterns of pemphigus in eastern India. The study also aims to correlate DIF with clinical and histologic findings as well as severity of skin involvement [scoring systems]. Materials and Methods: Total 41 patients were studied over a period of 1 year in the Post-graduate centre of Dermatology in Eastern India. DIF, histopathology and clinical data were correlated. Results: In our study Pemphigus vulgaris (PV) was the predominant type with 32 cases followed by 8 cases of pemphigus foliaceus (PF) and a single case of IgA pemphigus. Mean age at presentation was late middle age. Majority of the patients, 26 (63.41%) initially had cutaneous involvement followed by mucosal involvement. In this study group 36 (87.80%) patients showed acantholytic cells on histopathological examination. Most patients of PV showed suprabasal blister 20 (62.50%) followed by intraspinous 5 (15.62%) and subcorneal 5 (15.62%) blister. In majority 28 (87.50%) of the PV patients IgG and C3 antibodies were deposited throughout the epidermis. The strength of antibody positivity was strong in most of the patients (71.87%). In cases of PF mostly IgG 6 (75%) antibodies were deposited in the upper epidermis. DIF intensity had poor correlation with disease activity/severity except in PF. Conclusion: Almost 85.36% cases of pemphigus were diagnosed clinicopathologically. But 6 cases couldn’t be diagnosed accurately on clinicopathological basis and in them DIF was confirmatory. Two cases of pure mucosal PV and 1 case of IgA pemphigus was confirmed by DIF. Two cases of bullous pemphigoid clinico-histologically mimicking PV were also excluded by DIF. So it appears from our study that DIF is confirmatory for diagnosis of pemphigus in all cases. PMID:27293249

Mumps disease outbreak in Davangere district of Karnataka, India.

PubMed

Raut, C G; Sinha, D P; Jayaprakash, H; Hanumiah, H; Manjunatha, M J

2015-01-01

Mumps is a vaccine-preventable disease that usually occurs as a parotitis, but it can also lead to several life- threatening complications, including pancreatitis, meningitis and encephalitis. To determine and diagnosis of mumps disease, which is communicable disease usually affects childrens. Although it is seen worldwide, but outbreaks not common in India. Thirty one suspected mumps cases, who presented to the unimmunized population of Chikkahallivana village in Davangere district of Karnataka, India in January 2014, with clinical evidence of fever, cervical lymphadenitis and ear pain, manifest with self-limited uni-or bilateral parotitis. A total of 31 cases consisting of 31 blood and 31 throat swabs were tested for diagnosis of mumps disease. Of the 31 suspected cases, laboratory results showed 18 positive for mumps IgM antibodies and 7 cases showed presence of mumps virus RNA by RT-PCR using MV specific nested primers. From 31 cases, 5 were positive with both the methods. We confirmed the cases by serological as well as a sensitive RT-nested PCR-based method and sequencing results for the molecular identification of mumps infection. Sequencing results of the SH gene identified outbreak strain as genotype C, which was consistent with other outbreaks in India.

Local Economic Development and Hydropower Along the Brahmaputra River Basin in Northeast India

NASA Astrophysics Data System (ADS)

Mock, A.

2014-12-01

Large dams have long been controversial. They offer benefits, such as reduced greenhouse gas emissions, energy security, and local development, yet produce negative social and ecological impact, such as wildlife habitat destruction, human displacement, and the disruption of downstream fishing or agricultural industries. In the past decade, the Indian government has signed Memoranda of Understanding with hydroelectric power companies for the building of over 130 large dams on the Brahmaputra River in the state of Arunachal Pradesh in Northeast India. These dams can generate 43% of India's assessed hydropower potential to sustain India's growing economy. In addition, the Indian government claims that these dams will bring local development with needed jobs. However, local Arunachali people have protested and temporarily halted hydropower projects because of the impact of dams on their existing livelihoods. Using the North Eastern Electric Power Corporation's (NEEPCO) Ranganadi Hydroelectric Project as a case study, our project examined whether dams in Northeast India provide jobs for local people, and whether distance from the dam or work colony to a worker's hometown affects the type of job the worker received. Survey data from residents at NEEPCO's work colony in Doimukh, Arunachal Pradesh, was analyzed using SPSS (n = 18). Our research found that 100% of workers at the dam originally resided in Northeast India, with 33% from Arunachal Pradesh, and 67% from the nearby states of Assam, and Tripura. Further, our analysis revealed no statistically significant relationship between the distance to a worker's hometown and job type (p = .609). Where workers come from did not affect the type of job they received. More research using a larger sample size and additional hydroelectric project case studies is needed to further explore the relationship between worker home location and their job types.

Molecular characterization of wild-type measles viruses in Tamil Nadu, India, during 2005-2006: relationship of genotype D8 strains from Tamil Nadu to global strains.

PubMed

Duraisamy, Raja; Rota, Paul A; Palani, Gunasekaran; Elango, Varalakshmi; Sambasivam, Mohana; Lowe, Luis; Lopareva, Elena; Ramamurty, Nalini

2012-02-01

Molecular characterization of measles viruses is a valuable tool for measuring the effectiveness of measles control and elimination programmes. WHO recommends that virological surveillance be conducted during all phases of measles control to document circulation of indigenous strains and trace future importation. This report describes the genetic characterization of wild type measles viruses from Tamil Nadu, India isolated between January 2005 and January 2006. In the study, 304 suspected measles cases (292 from 56 outbreaks and 12 sporadic cases) were investigated. Blood samples were collected from suspected measles outbreaks and 11 suspected sporadic cases and tested for the presence of measles and rubella specific IgM. Based on serological results, 53 outbreaks were confirmed as measles, 2 as a combination of measles and rubella, and 1 negative for both. Eight sporadic cases were confirmed as measles and one as rubella. Throat swab and urine samples were collected for virus isolation and 28 isolates were obtained. Sequencing and analysis showed that 3 isolates belonged to genotype D4 and 25 to genotype D8. Comparison of the genotype D8 sequences from Tamil Nadu with previously reported genotype D8 sequences from India and abroad showed six distinct clusters with Tamil Nadu strains forming two clusters. This study has established baseline molecular data and is the first report that describes genetic diversity of circulating measles strains in Tamil Nadu, a state in India. D8 has multiple lineages and this has been linked with importation of measles into the USA and UK. Copyright © 2011 Wiley Periodicals, Inc.

Measles virus genotypes circulating in India, 2011-2015.

PubMed

Vaidya, Sunil R; Chowdhury, Deepika T

2017-05-01

The Government of India is accepted to participate in the measles elimination and rubella control goal 2020, hence genetic characterization of measles viruses (MeV) becomes essential. At National Reference Laboratory (National Institute of Virology, Pune), the throat swabs/urine specimens (n = 380) or PCR products (n = 219) obtained from the suspected measles cases were referred for the molecular testing and subsequently, MeV nucleoprotein (N) gene sequencing/genotyping. In addition, 2,449 suspected measles cases, mainly from the Maharashtra state were referred for the laboratory diagnosis. A detailed study was performed on N gene sequences obtained during last two decades. Indian MeV sequences obtained during 2011-2015 were compared with 1996-2010 sequences and genetic divergence was studied. Circulation of measles genotypes B3 (n = 3), D4 (n = 49), and D8 (n = 351) strains were observed in 19 States and three Union Territories of India. In addition, 64 measles viruses were isolated from 253 throat swab or urine specimens obtained from the suspected measles cases. During 2011-2015, 67.9% (1,663/2,449) suspected measles cases were laboratory confirmed. Molecular studies showed circulation of measles genotype B3 in India along with prominently circulating genotypes D4 and D8 except D7 strains. The genetic diversion within Indian B3, D4, and D8 genotypes was 0.3%, 1.1%, and 2.1%, respectively. The genetic divergence of Indian B3, D4, and D8 measles strains with the WHO reference sequences was 2.5%, 2.6%, and 1.8%, respectively. It is crucial data for national immunization program. More measles/rubella genotyping studies are necessary to track transmission and to support measles elimination and rubella control. J. Med. Virol. 89:753-758, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Can Mixed Parasite Infections Thwart Targeted Malaria Elimination Program in India?

PubMed

Singh, Upasana Shyamsunder; Siwal, Nisha; Pande, Veena; Das, Aparup

2017-01-01

India is highly endemic to malaria with prevalence of all five species of human malaria parasites of Plasmodium genus. India is set for malaria elimination by 2030. Since cases of mixed Plasmodium species infections remain usually undetected but cause huge disease burden, in order to understand the distributional prevalence of both monospecies infections and mixed species infections in India, we collated published data on the differential infection incidences of the five different malaria parasites based on PCR diagnostic assay. About 11% of total cases were due to mixed species infection. Among several interesting observations on both single and mixed parasitic infections, incidences of Plasmodium falciparum monoinfection were found to be significantly higher than P. vivax monoinfection. Also, P. malariae seems to be emerging as a potential malaria threat in India. Putting all the facts together, it appears that the dream of achieving malaria elimination in India will not be completely successful without dealing with mixed species infection.

Non-Formal Education--A Worthwhile Alternative to the Formal Education in India? Case Studies from Ganjam, Orissa. Reprints and Miniprints, No. 757.

ERIC Educational Resources Information Center

Svensson, Anna

This report discusses the advantages and disadvantages of non-formal education (NFE) compared to the formal school system in Ganjam, a rural district on the east coast of Orissa, India. The aim of the research was to investigate whether or not NFE, would be a worthy target of aid from the Swedish aid organization SIDA (Swedish International…

Are We Asking the Right Questions? Moving beyond the State vs Non-State Providers Debate: Reflections and a Case Study from India

ERIC Educational Resources Information Center

Bangay, Colin; Latham, Michael

2013-01-01

This paper provides an overview of recent trends in basic education provision in India: charting an impressive expansion of enrolment in public schools but a growing concern with the quality of learning. Concerns around quality are seen as a driving factor in the migration of students from the public sector to low fee private schools. While there…

A Family Study of Consanguinity in Children with Intellectual Disabilities in Barwani, India

PubMed Central

Lakhan, Ram; Bipeta, Rajshekhar; Yerramilli, Srinivasa S. R. R.; Nahar, Vinayak K.

2017-01-01

Background: Intellectual disability (ID) can be inherited in families through consanguineous marriage. The ID in an individual can be associated with the ID, epilepsy, and mental illness in their parents. Such connections can be seen more closely among consanguineous marriages in tribal and nontribal population in India. Objective: This study shows a few common patterns of the consanguineous relationship in the parents of children with ID in India. Materials and Methods: This is a case series research design. Extreme or deviant case sampling was applied. Data were collected in homes, camps, and clinical settings in the Barwani district of Madhya Pradesh, India. The patterns of consanguineous marriages and the relationship between children with ID and their relatives with ID, epilepsy, and mental illness were analyzed and reported with pedigree charts. Results: Multiple patterns of consanguineous marriages in tribal and nontribal populations were observed. ID was found to be associated in children with their relatives of the first, second, and third generations. Conclusion: ID may inherit in individuals from their relatives of the first, second, and third generations who have ID, epilepsy, or mental illness and married in the relationship. Appropriate knowledge, guidance, and counseling may be provided to potential couples before planning a consanguineous marriage. PMID:29204013

Susceptibility of Rubella Among Pregnant Women Attending the Antenatal Clinic in a Tertiary Care Hospital, Jabalpur, Central India.

PubMed

Kori, Bhupesh K; Singh, Kavita N; Sharma, Ravendra K; Sharma, Bhagwati S; Badkur, Poorva; Barde, Pradip V

2017-03-01

The purpose of this study was to evaluate rubella susceptibility of pregnant women from central India as rubella infection can be devastating for the newborn if it occurs in the mother in the first trimester of pregnancy, which may lead to congenital rubella syndrome (CRS). There are very few studies about seroprevalence of rubella from India and none from central India. The study was conducted among women attending the obstetric department of a tertiary care hospital, in which 369 antenatal cases were tested for the presence of immunoglobulin G antibody for rubella and its titer. Data were analyzed using statistical tests. A total of 141 (38.2%) women were found susceptible to rubella. There was no significant difference in rubella susceptibility among different socioeconomic classes, ages, and gravidity. A large proportion of pregnant women were found to be rubella susceptible, posing immense threat of CRS to their newborns. A robust program for rubella immunization targeting young adult women is needed to avoid CRS.

Review of past research and proposed action plan for landfill gas-to-energy applications in India.

PubMed

Siddiqui, Faisal Zia; Zaidi, Sadaf; Pandey, Suneel; Khan, Mohd Emran

2013-01-01

Open dumps employed for disposal of municipal solid waste (MSW) are generally referred to as landfills and have been traditionally used as the ultimate disposal method in India. The deposition of MSW in open dumps eventually leads to uncontrolled emission of landfill gas (LFG). This article reviews the MSW disposal practices and LFG emissions from landfills in India during the period 1994 to 2011. The worldwide trend of feasibility of LFG to energy recovery projects and recent studies in India indicate a changed perception of landfills as a source of energy. However, facilitating the implementation of LFG to energy involves a number of challenges in terms of technology, developing a standardized framework and availability of financial incentives. The legislative framework for promotion of LFG to energy projects in India has been reviewed and a comprehensive strategy and action plan for gainful LFG recovery is suggested. It is concluded that the market for LFG to energy projects is not mature in India. There are no on-ground case studies to demonstrate the feasibility of LFG to energy applications. Future research therefore should aim at LFG emission modeling studies at regional level and based on the results, pilot studies may be conducted for the potential sites in the country to establish LFG to energy recovery potential from these landfills.

Fusarium sacchari, a cause of mycotic keratitis among sugarcane farmers - a series of four cases from North India.

PubMed

Bansal, Yashik; Chander, Jagdish; Kaistha, Neelam; Singla, Nidhi; Sood, Sunandan; van Diepeningen, Anne D

2016-11-01

The two most common filamentous fungi causing mycotic keratitis are Aspergillus and Fusarium spp. Around 70 Fusarium spp. are involved in causing human infections. In this study, four cases of keratitis in sugarcane farmers in India are being reported, caused by the sugar cane pathogen Fusarium sacchari, a species of the Fusarium fujikuroi species complex. Fusarial keratitis was established by potassium hydroxide/Calcofluor white wet mounts and fungal culture of corneal scrapings on conventional media. Final identification was done by genetic sequencing at CBS-KNAW, Utrecht, The Netherlands. The antifungal susceptibility testing was done using broth microdilution method as per CLSI document M38-A2. Four cases of F. sacchari keratitis were identified. Three of them had trauma with sugarcane leaves, whereas one sugarcane farmer reported trauma by vegetative matter. The morphological similarities among various Fusarium species warrant use of molecular methods for identification of cryptic species. A wide distribution of sugarcane farming could be the possible explanation for emergence of F. sacchari keratitis in India. © 2016 Blackwell Verlag GmbH.

HIV in India: the Jogini culture

PubMed Central

Borick, Joseph

2014-01-01

Jogini is the name for a female sexually exploited temple attendant and is used interchangeably with Devadasi in the state of Andhra Pradesh, India. Jogini are twice more likely than other women who are used for sexual intercourse in India to be HIV positive, and their rate of mortality from HIV is 10 times the total mortality rate for all women in India. The four states in India with the most Jogini also have the highest prevalence of HIV. The following case is unfortunately typical of the Jogini and sheds light on a potentially disastrous public health problem in rural South India. PMID:25015167

Development, malaria and adaptation to climate change: a case study from India.

PubMed

Garg, Amit; Dhiman, R C; Bhattacharya, Sumana; Shukla, P R

2009-05-01

India has reasons to be concerned about climate change. Over 650 million people depend on climate-sensitive sectors, such as rain-fed agriculture and forestry, for livelihood and over 973 million people are exposed to vector borne malarial parasites. Projection of climatic factors indicates a wider exposure to malaria for the Indian population in the future. If precautionary measures are not taken and development processes are not managed properly some developmental activities, such as hydro-electric dams and irrigation canal systems, may also exacerbate breeding grounds for malaria. This article integrates climate change and developmental variables in articulating a framework for integrated impact assessment and adaptation responses, with malaria incidence in India as a case study. The climate change variables include temperature, rainfall, humidity, extreme events, and other secondary variables. Development variables are income levels, institutional mechanisms to implement preventive measures, infrastructure development that could promote malarial breeding grounds, and other policies. The case study indicates that sustainable development variables may sometimes reduce the adverse impacts on the system due to climate change alone, while it may sometimes also exacerbate these impacts if the development variables are not managed well and therefore they produce a negative impact on the system. The study concludes that well crafted and well managed developmental policies could result in enhanced resilience of communities and systems, and lower health impacts due to climate change.

Development, Malaria and Adaptation to Climate Change: A Case Study from India

NASA Astrophysics Data System (ADS)

Garg, Amit; Dhiman, R. C.; Bhattacharya, Sumana; Shukla, P. R.

2009-05-01

India has reasons to be concerned about climate change. Over 650 million people depend on climate-sensitive sectors, such as rain-fed agriculture and forestry, for livelihood and over 973 million people are exposed to vector borne malarial parasites. Projection of climatic factors indicates a wider exposure to malaria for the Indian population in the future. If precautionary measures are not taken and development processes are not managed properly some developmental activities, such as hydro-electric dams and irrigation canal systems, may also exacerbate breeding grounds for malaria. This article integrates climate change and developmental variables in articulating a framework for integrated impact assessment and adaptation responses, with malaria incidence in India as a case study. The climate change variables include temperature, rainfall, humidity, extreme events, and other secondary variables. Development variables are income levels, institutional mechanisms to implement preventive measures, infrastructure development that could promote malarial breeding grounds, and other policies. The case study indicates that sustainable development variables may sometimes reduce the adverse impacts on the system due to climate change alone, while it may sometimes also exacerbate these impacts if the development variables are not managed well and therefore they produce a negative impact on the system. The study concludes that well crafted and well managed developmental policies could result in enhanced resilience of communities and systems, and lower health impacts due to climate change.

Risk factors for severe acute malnutrition in children below 5 y of age in India: a case-control study.

PubMed

Mishra, Kirtisudha; Kumar, Praveen; Basu, Srikanta; Rai, Kiran; Aneja, Satinder

2014-08-01

To determine the possible risk factors for severe acute malnutrition (SAM) in children below 5 y admitted in a hospital in north India. This case-control study was conducted in a medical college hospital in children below 5 y of age. All cases of SAM (diagnosed as per WHO definition) between 6 and 59 mo of age were compared with age-matched controls with weight for height above -2SD of WHO 2006 growth standards. Data regarding socio-demographic parameters, feeding practices and immunization were compared between the groups by univariable and multivariable logistic regression models. A total of 76 cases and 115 controls were enrolled. Among the 14 factors compared, maternal illiteracy, daily family income less than Rs. 200, large family size, lack of exclusive breast feeding in first 6 mo, bottle feeding, administration of pre-lacteals, deprivation of colostrum and incomplete immunization were significant risk factors for SAM. Regarding complementary feeding, it was the consistency, rather than the age of initiation, frequency and variety which showed a significant influence on occurrence of SAM. Multivariate analysis revealed that the risk of SAM was independently associated with 6 factors, namely, illiteracy among mothers, incomplete immunization, practice of bottle feeding, consistency of complementary feeding, deprivation of colostrum and receipt of pre-lacteals at birth. The present study identifies certain risk factors which need to be focused on during health planning and policy making related to children with SAM in India.

The India Education Project: A Case Study of Institution Building and Organizational Conflict.

ERIC Educational Resources Information Center

Bhola, Harbans S.

This monograph, relating to events that happened during 1966-68, is a case study of a voluntary, educational, and intercultural organization that had been service oriented for almost 15 years. The organization had been organizing literacy classes, opening rural libraries, providing health extension, and conducting a small program of publication…

Scenario of organophosphate pollution and toxicity in India: A review.

PubMed

Kumar, Shardendu; Kaushik, Garima; Villarreal-Chiu, Juan Francisco

2016-05-01

The present study on organophosphate deals with the reports on pollution and toxicity cases throughout India. The use of pesticides was introduced in India during the 1960s which are now being used on a large scale and represents the common feature of Indian agriculture. Use of organophosphates as a pesticide came as an alternative to chlorinated hydrocarbons due to their easy degradability. Although these xenobiotics degrade under natural condition, their residues have been detected in soil, sediments, and water due to their non-regulated usage practice. The over-reliance on pesticides has not only threatened our environment but contaminations of organophosphate residues have been also detected in certain agricultural products like tea, sugars, vegetables, and fruits throughout India. This paper highlights many of the cases where different organophosphates have been detected exceeding their respective MRL values. Some organophosphates detected are so hazardous that even WHO has listed them in class 1a and class 1b hazardous group. Presence of their residues in blood, milk, honey, and tissues of human and animals revealed their excessive use and bioaccumulating capabilities. Their intentional or unintentional uptake is causing thousands of deaths and severity each year. Most of the toxicity cases presented here are due to their uptake during a suicidal attempt. This shows how easily these harmful substances are available in the market.

Genetic biodiversity of Mycobacterium tuberculosis isolates from patients with pulmonary tuberculosis in India.

PubMed

Singh, Urvashi Balbir; Arora, Jyoti; Suresh, Naga; Pant, Hema; Rana, Tanu; Sola, Christophe; Rastogi, Nalin; Pande, Jitendra Nath

2007-07-01

Spoligotyping was performed on 540 Mycobacterium tuberculosis isolates in order to evaluate the genetic biodiversity of tubercle bacilli in India. One hundred and forty seven patterns were unique and 393 were grouped in 48 clusters. Comparison with an international spoligotype database showed that the most predominant clades among tuberculosis (TB) isolates were Central Asian (CAS) and East-African Indian (EAI) with shared-types (ST) ST26 and ST11 alone being responsible for 34% of all TB cases. Twenty one (3.8%) isolates belonged to the Beijing genotype. Marked variations were observed among circulating strains, STs belonging to CAS family predominated in the North, whereas the EAI family was more common in the Southern India. TB in India is predominantly caused by strains belonging to the principal genetic group 1 (PGG1), suggesting that most of the TB burden in India may be traced to ancestral clones of the tubercle bacilli. This study gives an insight into the global M. tuberculosis genetic biodiversity in India, the predominant spoligotypes and their impact on disease transmission.

Role of Voluntary Organizations in Astronomy Popularization: A case study of "Khagol Mandal", Mumbai, India.

NASA Astrophysics Data System (ADS)

Sule, A.; Joshi, S.; Deshpande, A.; Joglekar, H.; Soman, Y.

2006-08-01

In India, Astronomy research institutions are few and far spaced as compared to the population density. Further, the public outreach activities of research institutes cannot cover most of the academic institutes in their area as they way out-number public outreach resource potential of any institute. The organisations of amateur astronomy enthusiasts do come handy in this scenario. We here present a case study of "Khagol Mandal", an a voluntary organisation primarily based in Mumbai, India's economic capital. In 20 years since its inception in 1985-86, Khagol Mandal has given more than 1000 public outreach programmes in various schools, undergraduate colleges, famous city hangouts, apart from their regular overnight programmes in Vangani, a sleepy village on the outskirts of the city. Study tours on special occasions like TSE'95 and TSE'99 as well as regular study tours to meteor crater at Lonar, Maharashtra facilitate their volunteers with glimpses of real research work in astronomy. These have inspired a number of students to take professional astronomy careers. With a volunteer force, probably largest in India or even South Asia, Khagol Mandal is well poised to take advantage of the newest tools like the Virtual Observatory and make the use of existing goodwill to take these tools to the layman. With little guidance from senior researchers, organisations like these can provide a solution to ever increasing need of man power for secondary data analysis.

Cost-effectiveness and cost utility of community screening for glaucoma in urban India.

PubMed

John, Denny; Parikh, Rajul

2017-07-01

Population-based screening for glaucoma has been demonstrated to be cost-effective if targeted at high-risk groups such as older adults and those with a family history of glaucoma, and through use of a technician for conducting initial assessment rather than a medical specialist. This study attempts to investigate the cost-effectiveness of a hypothetical community screening and subsequent treatment programme for glaucoma in comparison with current practice (i.e. with no screening programme but with some opportunistic case finding) in the urban areas of India. A hypothetical screening programme for both primary open-angle glaucoma and angle-closure disease was built for a population aged between 40 and 69 years in the urban areas of India. Screening and treatment costs were obtained from an administrator of a tertiary eye hospital in India. The probabilities for the screening pathway were derived from published literature and expert opinion. The glaucoma prevalence rates for urban areas were adapted from the Chennai Glaucoma Study findings. A decision-analytical model using TreeAge Pro 2015 was built to model events, costs and treatment pathways. One-way sensitivity analyses were conducted. The introduction of a community screening programme for glaucoma is likely to be cost-effective, the estimated incremental cost-effectiveness ratio (ICER) values being 10,668.68 when compared with no screening programme and would treat an additional 4443 cases and prevent 1790 person-years of blindness over a 10-year period in the urban areas of India. Sensitivity analyses revealed that glaucoma prevalence rates across various age groups, screening uptake rate, follow-up compliance after screening, treatment costs and utility values of health states associated with medical and surgical treatment of glaucoma had an impact on the ICER values of the screening programme. In comparison with current practice (i.e. without a screening programme but with some opportunistic case finding), the introduction of a community screening programme for glaucoma for the 40-69 years age group is likely to be relatively cost-effective if implemented in the urban areas of India. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Mobilization and Involvement of Students and Teachers in Implementing the Adult and Extension Education Programmes at the Grass-Root Level with Special Reference to Bharathidasan University, Tiruchirapalli, India: A Case Study.

ERIC Educational Resources Information Center

Parthasarthy, K.; Balasaravanan, T.

India has made considerable progress toward universal primary education but has the dubious distinction of having the highest illiteracy rates in the world. Stringent endeavors are being made at the national, state, and district levels to eradicate illiteracy through mass approaches and programs. Extension is recognized as the third dimension of…

Burden of psychiatric morbidity among attendees of a secondary level hospital in Northern India: Implications for integration of mental health care at subdistrict level.

PubMed

Haldar, Partha; Sagar, Rajesh; Malhotra, Sumit; Kant, Shashi

2017-01-01

There is little information available on the type, pattern, trend, and demographic differentials of psychiatric cases attending a subdistrict level facility in India. Our objectives were to describe the sociodemographic profile of the patients availing the psychiatric outpatient department services and document the diagnosis. This study is based on a retrospective analysis of routinely recorded administrative data collected during psychiatry consultations that took place between January 2010 and June 2014, at the subdistrict level hospital, Ballabgarh, Faridabad district, Haryana, Northern India. The data were abstracted in Microsoft Excel, scrutinized for duplicates, and cleaned in terms of the International Classification of Diseases 10 th Revision coding. Descriptive analysis was done for dependent variables and continuous variables were compared using independent t -test. A total of 2806 people (new registrations) were provided psychiatric consultations between January 2010 and June 2014. The mean age of males was 33.7 years (95% confidence interval [CI], 32.9, 34.5) and of females was 35.6 years (95% CI, 34.9, 36.3). Neurotic, stress-related, and somatoform disorders (F40-F48) comprised the major category of diagnoses with 661 cases (24%), followed by unspecified mental disorders (F99) with 528 cases (19%), mood (affective) disorders (F30-F39) with 448 cases (16%), and episodic and paroxysmal disorders (G40-G47) with 334 cases (12%). We reported an increase in level and trend in the monthly attendance of patients who required psychiatric at a secondary care hospital in Northern India. We suggest that setting up of mental health units only at district hospital might not be a sufficient health system's approach as has been envisaged under the District Mental Health Program.

Smear Conversion, Treatment Outcomes and the Time of Default in Registered Tuberculosis Patients on RNTCP DOTS in Puducherry, Southern India

PubMed Central

Jayakumar, Niranjana; Gnanasekaran, Dhivyalakshmi

2014-01-01

Background: Revised National Tuberculosis Control Programme (RNTCP) in India has achieved improved cure rates. Objectives: This study describes the achievements under RNTCP in terms of conversion rates, treatment outcomes and pattern of time of default in patients on directly observed short-course treatment for Tuberculosis in Puducherry, Southern India. Settings: Retrospective cohort study; Tuberculosis Unit in District Tuberculosis Centre, Puducherry, India. Materials and Methods: Cohort analysis of patients of registered at the Tuberculosis Unit during 1st and 2nd quarter of the year 2011. Details about sputum conversion, treatment outcome and time of default were obtained from the tuberculosis register. Statistical Analysis: Kaplan-Meier plots & log rank tests. Results: RNTCP targets with respect to success rate (85.7%), death rate (2.7%) and failure rate (2.1%) in new cases have been achieved but the sputum conversion rate (88%) and default rate (5.9%) targets have not been achieved. The overall default rate for all registered TB patients was 7.4%; significantly higher in category II. In retreatment cases registered as treatment after default, the default rate was high (9%). The cumulative default rate; though similar in the initial two months of treatment; was consistently higher in category II as compared to that in category I. Nearly 40% of all defaulters interrupted treatment between the second and fourth month after treatment initiation. Conclusion: Defaulting from treatment is more common among the retreatment cases and usually occurs during the transition phase from intensive phase to continuation phase. PMID:25478371

Burden of asymptomatic malaria among a tribal population in a forested village of central India: a hidden challenge for malaria control in India.

PubMed

Chourasia, M K; Raghavendra, K; Bhatt, R M; Swain, D K; Valecha, N; Kleinschmidt, I

2017-06-01

Chhattisgarh in India is a malaria-endemic state with seven southern districts that contributes approximately 50-60% of the reported malaria cases in the state every year. The problem is further complicated due to asymptomatic malaria cases which are largely responsible for persistent transmission. This study was undertaken in one of the forested villages of the Keshkal subdistrict in Kondagaon district to ascertain the proportion of the population harbouring subclinical malarial infections. Community-based cross-sectional study. Mass blood surveys were undertaken of the entire population of the village in the post-monsoon seasons of 2013 and 2014. Fingerprick blood smears were prepared from individuals of all ages to detect malaria infections in their blood. Individuals with fever at the time of the survey were tested with rapid diagnostic tests, and parasitaemia in thick blood smears was confirmed by microscopy. Malaria-positive cases were treated with anti-malarials in accordance with the national drug policy. Peripheral blood smears of 134 and 159 individuals, including children, were screened for malaria infection in 2013 and 2014, respectively. Overall, the malaria slide positivity rates were 27.6% and 27.7% in 2013 and 2014, respectively, and the prevalence rates of asymptomatic malaria were 20% and 22.8%. This study showed that, for two consecutive years, the prevalence of asymptomatic malaria infection was significantly higher among children aged ≤14 years (34.4% and 34.1% for 2013 and 2014, respectively) compared with adults (15.2% and 18.2% for 2013 and 2014, respectively; P = 0.023 and 0.04, respectively). The number of asymptomatic malaria cases, especially Plasmodium falciparum, is significant, reinforcing the underlying challenge facing the malaria elimination programme in India. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Ocular sparganosis from Assam

PubMed Central

Nath, Reema; Gogoi, Rajendra Nath

2015-01-01

Sparganosis is caused by plerocercoid larvae of the Pseudophyllidea tapeworms of the genus Spirometra. Though prevalent in East Asian and south east Asian countries like China, Japan, Korea, Taiwan, Vietnam, Thailand; yet very few cases are reported from India. We report a case of migrating sub-conjunctival ocular sparganosis mimicking scleritis which later on developed into orbital cellulitis from Dibrugarh, Assam, North-eastern part of India. This case is reported for its rarity. PMID:25709957

Clinical and Laboratory Analysis of Patients with Leishmaniasis: A Retrospective Study from a Tertiary Care Center in New Delhi

PubMed Central

GUPTA, Nitin; KANT, Kamla; MIRDHA, Bijay Ranjan

2017-01-01

Background: Leishmaniasis manifests as visceral (VL), cutaneous (CL) or a dermal sequel of VL, known as Post kala-azar dermal leishmaniasis (PKDL). The aim of the study was to analyze the clinical and laboratory features of cases diagnosed with leishmaniasis. Methods: This hospital-based retrospective study included all cases of VL, PKDL, and CL diagnosed between Jan 2011 to Jan 2016 at All India Institute of Medical Sciences, New Delhi. Clinical and laboratory profile of the diagnosed cases were analyzed in detail. All diagnosed cases were mapped according to the state and the district from which the cases originated. Results: A total of 91 VL cases and 4 PKDL cases were reviewed. Only one case of CL (1 female) and mucocutaneous leishmaniasis (1 female) were observed during the study period. Majority of the cases of VL (75/91) originated from Bihar. The most common presenting symptoms in all our patients were fever (97.8%), weight loss (40.6%) and abdominal discomfort (17.6%) while the most common presenting signs were hepatosplenomegaly (45.8%), isolated splenomegaly (23.1%) and skin pigmentation (11%). The most common laboratory abnormality was anaemia followed by thrombocytopenia and leucopenia. Conclusion: VL is globally recognized as a neglected tropical disease. Even after continued effort to bring down its transmission in India, it continues to affect the endemic states with reports from new pockets. PMID:29317889

Impacts of urbanization on Indian summer monsoon rainfall extremes

NASA Astrophysics Data System (ADS)

Shastri, Hiteshri; Paul, Supantha; Ghosh, Subimal; Karmakar, Subhankar

2015-01-01

areas have different climatology with respect to their rural surroundings. Though urbanization is a worldwide phenomenon, it is especially prevalent in India, where urban areas have experienced an unprecedented rate of growth over the last 30 years. Here we take up an observational study to understand the influence of urbanization on the characteristics of precipitation (specifically extremes) in India. We identify 42 urban regions and compare their extreme rainfall characteristics with those of surrounding rural areas. We observe that, on an overall scale, the urban signatures on extreme rainfall are not prominently and consistently visible, but they are spatially nonuniform. Zonal analysis reveals significant impacts of urbanization on extreme rainfall in central and western regions of India. An additional examination, to understand the influences of urbanization on heavy rainfall climatology, is carried with station level data using a statistical method, quantile regression. This is performed for the most populated city of India, Mumbai, in pair with a nearby nonurban area, Alibaug; both having similar geographic location. The derived extreme rainfall regression quantiles reveal the sensitivity of extreme rainfall events to the increased urbanization. Overall the study identifies the climatological zones in India, where increased urbanization affects regional rainfall pattern and extremes, with a detailed case study of Mumbai. This also calls attention to the need of further experimental investigation, for the identification of the key climatological processes, in different regions of India, affected by increased urbanization.

Co-circulation and co-infections of all dengue virus serotypes in Hyderabad, India 2014.

PubMed

Vaddadi, K; Gandikota, C; Jain, P K; Prasad, V S V; Venkataramana, M

2017-09-01

The burden of dengue virus infections increased globally during recent years. Though India is considered as dengue hyper-endemic country, limited data are available on disease epidemiology. The present study includes molecular characterization of dengue virus strains occurred in Hyderabad, India, during the year 2014. A total of 120 febrile cases were recruited for this study, which includes only children and 41 were serologically confirmed for dengue positive infections using non-structural (NS1) and/or IgG/IgM ELISA tests. RT-PCR, nucleotide sequencing and evolutionary analyses were carried out to identify the circulating serotypes/genotypes. The data indicated a high percent of severe dengue (63%) in primary infections. Simultaneous circulation of all four serotypes and co-infections were observed for the first time in Hyderabad, India. In total, 15 patients were co-infected with more than one dengue serotype and 12 (80%) of them had severe dengue. One of the striking findings of the present study is the identification of serotype Den-1 as the first report from this region and this strain showed close relatedness to the Thailand 1980 strains but not to any of the strains reported from India until now. Phylogenetically, all four strains of the present study showed close relatedness to the strains, which are reported to be high virulent.

Maternal Health Situation in India: A Case Study

PubMed Central

Mavalankar, Dileep V.; Ramani, K.V.; Upadhyaya, Mudita; Sharma, Bharati; Iyengar, Sharad; Gupta, Vikram; Iyengar, Kirti

2009-01-01

Since the beginning of the Safe Motherhood Initiative, India has accounted for at least a quarter of maternal deaths reported globally. India's goal is to lower maternal mortality to less than 100 per 100,000 livebirths but that is still far away despite its programmatic efforts and rapid economic progress over the past two decades. Geographical vastness and sociocultural diversity mean that maternal mortality varies across the states, and uniform implementation of health-sector reforms is not possible. The case study analyzes the trends in maternal mortality nationally, the maternal healthcare-delivery system at different levels, and the implementation of national maternal health programmes, including recent innovative strategies. It identifies the causes for limited success in improving maternal health and suggests measures to rectify them. It recommends better reporting of maternal deaths and implementation of evidence-based, focused strategies along with effective monitoring for rapid progress. It also stresses the need for regulation of the private sector and encourages further public-private partnerships and policies, along with a strong political will and improved management capacity for improving maternal health. PMID:19489415

Mycobacterium tuberculosis Whole Genome Sequences From Southern India Suggest Novel Resistance Mechanisms and the Need for Region-Specific Diagnostics.

PubMed

Manson, Abigail L; Abeel, Thomas; Galagan, James E; Sundaramurthi, Jagadish Chandrabose; Salazar, Alex; Gehrmann, Thies; Shanmugam, Siva Kumar; Palaniyandi, Kannan; Narayanan, Sujatha; Swaminathan, Soumya; Earl, Ashlee M

2017-06-01

India is home to 25% of all tuberculosis cases and the second highest number of multidrug resistant cases worldwide. However, little is known about the genetic diversity and resistance determinants of Indian Mycobacterium tuberculosis, particularly for the primary lineages found in India, lineages 1 and 3. We whole genome sequenced 223 randomly selected M. tuberculosis strains from 196 patients within the Tiruvallur and Madurai districts of Tamil Nadu in Southern India. Using comparative genomics, we examined genetic diversity, transmission patterns, and evolution of resistance. Genomic analyses revealed (11) prevalence of strains from lineages 1 and 3, (11) recent transmission of strains among patients from the same treatment centers, (11) emergence of drug resistance within patients over time, (11) resistance gained in an order typical of strains from different lineages and geographies, (11) underperformance of known resistance-conferring mutations to explain phenotypic resistance in Indian strains relative to studies focused on other geographies, and (11) the possibility that resistance arose through mutations not previously implicated in resistance, or through infections with multiple strains that confound genotype-based prediction of resistance. In addition to substantially expanding the genomic perspectives of lineages 1 and 3, sequencing and analysis of M. tuberculosis whole genomes from Southern India highlight challenges of infection control and rapid diagnosis of resistant tuberculosis using current technologies. Further studies are needed to fully explore the complement of diversity and resistance determinants within endemic M. tuberculosis populations. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Probable psychiatric disorder in a rural community of West Bengal, India.

PubMed

Barik, Anamitra; Sarkhel, Sujit; Basu, Saugata; Chowdhury, Abhijit; Rai, Rajesh Kumar

2017-12-01

India faces multiple challenges to mitigate a high burden of psychiatric disorders. The risk of developing psychiatric disorder among the rural Indian population is poorly investigated. This study aims to understand the factors associated with probable psychiatric disorder (PPD) among a select rural Indian population. Data from the Birbhum population project of the society for health and demographic surveillance, West Bengal, India, were utilized. Cross-sectional data covering a sample of 31,135 respondents (male 15,384 and female 15,751) aged ≥ 16 years were used. The General Health Questionnaire-28 was administered and the responses were computed into three categories: psychological case, psychological caseness, and normal. Bivariate and multivariate ordered logit regression analyses were applied to attain the study objective. Of the total population, 26% of respondents were identified with PPD. People aged ≥ 60 years, females, divorced/separated/widowed individuals, the unemployed and people with no formal education, individuals from the poorest economic group, and people with a history of selling or mortgaging assets towards their healthcare expenditure had a higher prevalence of psychiatric case within their respective group. A high burden of PPD was estimated in the select rural community. While designing an intervention for measuring and addressing psychiatric disorders, the socioeconomic gradient of PPD could be helpful.

Leprosy trends at a tertiary care hospital in Mumbai, India, from 2008 to 2015.

PubMed

Muthuvel, Thirumugam; Isaakidis, Petros; Shewade, Hemant Deepak; Kattuppara, Lucy; Singh, Rajbir; Govindarajulu, Srinivas

2016-01-01

Leprosy remains an important cause of preventable disabilities. After the advent of multidrug therapy, new leprosy cases have come down dramatically. Despite this achievement, India, which contributes 60% of the global leprosy burden, faces some challenges to eliminate the disease, including active transmission in the community and delayed diagnosis of leprosy patients. The objectives of the study were 1) to determine sociodemographic and clinical characteristics of newly diagnosed adults and children (less than 15 years) with leprosy and their trends over time (2008-2015) and 2) to describe the profile of surgical procedures among leprosy patients registered for reconstructive surgeries during 2006-2015. Retrospective descriptive study was conducted involving a record review of new patients with leprosy registered in Vimala Dermatological Centre, Mumbai. A total of 578 new leprosy cases were registered in the hospital during 2008-2015. There has been a steady increase in the trend of child cases (less than 15 years) registered in the facility (from 3% in 2008 to 18% in 2015), x 2 =12.11, p< 0.01. The majority of the patients (68%) were migrants of Uttar Pradesh and Bihar. Targeting children and migrants and ensuring early diagnosis and treatment initiation are essential components for leprosy elimination in an urban metropolis in India.

Quality Assessment of Family Planning Sterilization Services at Health Care Facilities: Case Record Audit.

PubMed

Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet

2017-05-01

Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.

High proportion of modern genotypes of M. tuberculosis and their affinity with drug resistance in northern region of India.

PubMed

Dhatwalia, Sunil Kumar; Yadav, Rakesh; Behera, Digambar; Kaur, Harsimran; Kumar, Manoj; Sethi, Sunil

2017-09-01

Comparative genomics on the basis of TbD1 deletion has differentiated the members of Mycobacterium tuberculosis complex (MTC) in two major genogroups. They exhibit differential distribution and virulence potential. The present study was carried out to see the proportion of these genogroups and their association with drug resistance. The drug resistance pattern of 205 culture positive cases of M. tuberculosis and their relation with TbD1 deletion was analysed from the tertiary care centre. Overall proportion of genotypes (TbD1- and Tbd1+) and their association with drug resistance was also observed from the various studies from India. Our study reports that 85.4% of the isolates of M. tuberculosis were modern genotypes (TbD1-) and rest of 14.6% were ancient genotypes (TbD1+). 37 cases were of multiple drug resistant-TB (MDR-TB), 35 of them belongs to modern genogrop and rest of (2) were in ancient genogroup (p=0.12). Overall pooled estimate of proportion of modern genotype is 75.5% (CI 95%, 73.03-77.87) and 24.55% (CI 95%, 22.13-26.97) for ancient genotypes from the studies carried out in India. Modern genotypes were more rarely drug sensitive phenotypes with a relative risk (RR) of 0.89 (CI 95%, 0.74-1.07) while MDR cases were more in this group with an odds ratio (OR) of 2.27 (CI 95%, 0-1.07). This study demonstrates a higher proportion of modern genotypes in our region/India; which are more likely to be associated with drug resistance. Future, epidemiological/in vitro studies are required to ascertain the relationship between genotypes and their virulence potential. Copyright © 2017 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

Inactivated polio vaccine: time to introduce it in India's national immunization schedule.

PubMed

Verma, Ramesh; Khanna, Pardeep; Chawla, Suraj

2012-07-01

Polio is a communicable disease caused by poliovirus that may attack nerve cells of the brain and spinal cord. The victims develop neurological complications, likes stiffness of the neck, muscular weakness, or paralysis of one or more limbs. In severe cases, it may be fatal due to respiratory paralysis. The world has seen tremendous gains in polio eradication over the past year. India and Nigeria saw a reduction in cases of almost 95% from 2009 to 2010, and cases of wild poliovirus type 3 (WPV3) fell by 92% globally over the same period. In fact, no case has been reported in India since February 2011, such that India may be on the verge of eradicating polio. Nevertheless, polio control experts are particularly worried about Vaccine-Derived Poliovirus (VDPV). Global surveillance efforts picked up 430 cases of VDPV from several countries between July 2009 and March 2011. In India, 7 cases of VDPV were reported during the year 2011. As long as OPV is used, virologists say that the world is at risk of VDPV causing polio in unprotected children. Achieving a polio-free world will require the "cessation of all OPV" and with it the elimination of the risk of vaccine-associated paralytic polio (VAPP) or VDPV infections. To this effect, in 2011 the Global Polio Eradication Initiative (GPEI) will produce and develop a new roadmap for VDPV Elimination. Several countries have shifted from all OPV to sequential OPV-IPV schedules and all-IPV schedules with elimination of live poliovirus. IPV will be indispensable in the post-eradication era when use of OPV has to stop but "vaccination against polio" cannot stop. IPV offers complete individual protection and has been considered as an additional tool at present for those who can afford the vaccine, and since we are nearing the eradication of polio, it is time to shift from OPV to sequential OPV-IPV schedule in India. Such a strategy will avoid inevitable problems with VAPP.

Characteristics of gallbladder cancer in South India.

PubMed

Sachidananda, Sandeep; Krishnan, Arunkumar; Janani, K; Alexander, P C; Velayutham, Vimalraj; Rajagopal, Surendran; Venkataraman, Jayanthi

2012-09-01

Gallbladder cancer is common in north India. It is also a well established fact that gall bladder cancer is frequently associated with gallstone disease in north India, similar to reports from the West. The magnitude of the problem of gallbladder cancer in south India and its link to gallstone disease is not clearly established. The aim of the study was to determine retrospectively, the characteristics of individuals with GBC in south India and to determine its association with gallstone disease. Retrospective data was obtained from records of proven cases of gallbladder cancer and patients undergoing cholecystectomy for gallstone disease between Jan 2001 and Dec 2010. Data retrieved included age, gender, and clinical presentation, findings on imaging, histology and details of management. The number of proven cases of gallbladder cancer each year ranged from 8 to 17. There were 38 men and 23 women. Male female ratio was 1.6:1. There were more men in the successive decades. Right upper quadrant pain (42 %) followed by jaundice (27 %) and a presence of a palpable mass (12 %) were the common clinical presentation. Pre-operative diagnosis of gall bladder cancer was possible in 80 %. Twelve patients had co-existing gallstones (19.6 %). Forty patients (50 %) had stage IV disease; only 6 patients had Stage I operable disease (9.8 %). During the same time 758 patients had cholecystectomy for gallstone disease. Only one patient had an incidental gall bladder cancer, who had an extended cholecystectomy. Gallbladder cancer is uncommon in south India and its association with gallstone is also low.

Language and Literacy: The Case of India.

ERIC Educational Resources Information Center

Sridhar, Kamal K.

Language and literacy issues in India are reviewed in terms of background, steps taken to combat illiteracy, and some problems associated with literacy. The following facts are noted: India has 106 languages spoken by more than 685 million people, there are several minor script systems, a major language has different dialects, a language may use…

Teaching Excellence and Innovative Practices: A Case Study of National Awardee Teachers of India

ERIC Educational Resources Information Center

Sengupta, Aparajita; Tyagi, Harish Kumar

2016-01-01

Aim: The study intended to identify the contributions of the National awardee teachers to the teaching learning process through their teaching excellence and innovative practices which can act as exemplary model for the entire teaching community. Method: Attempts has been made to carry out a qualitative study where two selected cases are based on…

Virtual Trust in US-India Global Outsource Teams: A Qualitative Exploratory Case Study

ERIC Educational Resources Information Center

Gugliotti, Domenic

2017-01-01

The purpose of this qualitative exploratory case study was to identify and analyze, trust behaviors used by members of an outsourced virtual team in an on and offshore engagement. The inability to build trust in outsourced engagements can cause serious damage to the collaboration within the virtual team causing it to fail. This study provides…

Progress toward poliomyelitis eradication --- India, January 2009-October 2010.

PubMed

2010-12-10

India is one of only four countries (including Afghanistan, Nigeria, and Pakistan) where wild poliovirus (WPV) transmission has never been interrupted. Historically, WPV transmission in India has centered largely in Uttar Pradesh and Bihar, two states with low routine vaccination coverage, large migrant and remote populations, and lower relative vaccine effectiveness than other areas of the country. However, during a 9-month period from November 2009 to August 2010, no WPV type 1 (WPV1) cases were reported in Uttar Pradesh or Bihar. This report summarizes the substantial progress made in India toward polio eradication during January 2009-October 2010, according to data reported as of December 4, and updates previous reports. During January-October 2010, only 40 WPV cases were confirmed in India, a 94% decrease from the 626 WPV cases confirmed during the same period in 2009; the decrease likely resulted, in large part, from the introduction of bivalent oral poliovirus vaccine types 1 and 3 (bOPV). Increasingly important contributors to WPV transmission are large migrant subpopulations; surveys have indicated that up to 11% of children aged <5 years in these subpopulations were missed during supplementary immunization activities (SIAs). Interruption of all WPV transmission in India will require maintaining high levels of immunity in Uttar Pradesh and Bihar and additional efforts directed toward children in migrant subpopulations that are not vaccinated as readily during SIAs.

Efficacy and safety of golimumab in Indian patients with rheumatoid arthritis: Subgroup data from GO-MORE study.

PubMed

Pal, Sarvajeet; Veeravalli, Sarath Chandra Mouli; Das, Siddharth Kumar; Shobha, Vineeta; Uppuluri, Ramakrishna Rao; Dharmanand, B G; Nadkar, Milind; Hsia, Elizabeth; Fei, Kaiyin; Yao, Ruji; Khalifa, Ahmed

2016-11-01

To conduct a subgroup analysis of GO-MORE trial Part 1, comparing efficacy and safety of add-on subcutaneous golimumab therapy in rheumatoid arthritis (RA) patients enrolled from and outside India. GO-MORE was an open-label, multicenter, prospective trial of add-on golimumab in biologic-naïve RA patients, having active disease despite being on conventional DMARD regimen(s). Part 1 of the study was chosen as the focus of this subgroup analysis because a substantial number of Indian patients (106) were enrolled compared to no Indian patients in Part 2. The primary efficacy outcome was proportion of patients achieving good to moderate DAS28-ESR (Disease Activity Score of 28 joints calculated using erythrocyte sedimentation rate) European League Against Rheumatism (EULAR) response at month 6. Efficacy evaluable population comprised of 105 and 3175 patients from India and outside India, respectively. Safety analysis included 106 patients enrolled from India and 3251 from outside India. A higher proportion of Indian patients had a high disease activity as measured by DAS28 ESR than outside India patients. At month 6, the proportion of Indian and non-Indian patients achieving DAS28-ESR, DAS28 - C-reactive protein, simplified disease activity index (SDAI) remission, and EuroQoL Quality-of-Life Questionnaire (EQ-5D) scores were comparable. Incidence of all adverse events was lower in Indian patients. There were no deaths, cases of tuberculosis or malignancy reported in the patients from India at month 6. The efficacy and safety results with add-on golimumab were consistent between RA patients from India and outside India, despite high baseline disease activity in the Indian patients. © 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Molecular detection and genetic diversity of Babesia gibsoni in dogs in India.

PubMed

Singh, M N; Raina, O K; Sankar, M; Rialch, Ajayta; Tigga, M N; Kumar, G Ravi; Banerjee, P S

2016-07-01

Babesia gibsoni is a tick borne intraerythrocytic protozoan parasite causing piroplasmosis in dogs and has been predominantly reported in Asian countries, including Japan, Korea, Taiwan, Malaysia, Bangladesh and India. The present communication is the first evidence on the genetic diversity of B. gibsoni of dogs in India. Blood samples were collected from 164 dogs in north and northeast states of India and 13 dogs (7.9%) were found positive for B. gibsoni infection by microscopic examination of blood smears. Molecular confirmation of these microscopic positive cases for B. gibsoni was carried out by 18S rRNA nested-PCR, followed by sequencing. Nested-PCR for the 18S rRNA gene was also carried out on microscopically B. gibsoni negative samples that detected a higher percentage of dogs (28.6%) infected with B. gibsoni. Genetic diversity in B. gibsoni in India was determined by studying B. gibsoni thrombospondin-related adhesive protein (BgTRAP) gene fragments (855bp) in 19 isolates from four north and northeast states of India. Phylogenetic analysis of the BgTRAP gene revealed that B. gibsoni parasite in India and Bangladesh formed a distinct cluster away from other Asian B. gibsoni isolates available from Japan, Taiwan and Korea. In addition, tandem repeat analysis of the BgTRAP gene clearly showed considerable genetic variation among Indian isolates that was shared by B. gibsoni isolates of Bangladesh. These results suggested that B. gibsoni parasites in a different genetic clade are endemic in dogs in India and Bangladesh. Further studies are required for better understanding of the genetic diversity of B. gibsoni prevalent in India and in its neighbouring countries. Copyright © 2016 Elsevier B.V. All rights reserved.

Without Women No Development: Selected Case Studies from Asia of Non-Formal Education for Women.

ERIC Educational Resources Information Center

Shah, Madhuri, Ed.

This handbook presents 15 case studies on the non-formal education of women from four Asian countries: India, Bangladesh, Sri Lanka, and Malaysia. The goal of this publication is to provide information about education-related issues concerning women and girls and development. This information is intended for those people, in governmental and…

Cancer: scenario and relationship of different geographical areas of the globe with special reference to North East-India.

PubMed

Sharma, Jagannath Dev; Kalit, Manoj; Nirmolia, Tulika; Saikia, Sidhartha Protim; Sharma, Arpita; Barman, Debanjana

2014-01-01

Cancer is becoming the most important public health burden around the globe. As per the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths were estimated to have occurred in 2008. The burden of cancer cases for India in the year 2020 is calculated to be 1,148,757 (male 534,353; female 614,404) compared to 979,786 in 2010. The pattern of cancer incidence is varying among geographical regions, esophageal cancer for example being high in China, lung cancer in USA, and gallbladder cancer in Chile. The question remains why? Is it due to the diversity in genome pool, food habits, risk factor association and role of genetic susceptibility or some other factors associated with it? In India, the North East (NE)-India region is seeing a marked increase in cancer incidence and deaths, with a very different cancer incidence pattern compared to mainland India. The genome pool of the region is also quite distinct from the rest of India. Northeastern tribes are quite distinct from other groups; they are more closely related to East Asians than to other Indians. In this paper an attempt was made to see whether there is any similarity among the pattern of cancer incidence cases for different sites of NE-India region to South or East-Asia. Principal Component Analysis (PCA), Hierarchical Cluster Analysis (HCA), Pearson Correlation coefficient test was assessed to evaluate the linkage of North-East India region to other regions. A p value <0.05 was considered as statistically significant. The results clearly shows that there are similarities in occurrence of cancer incidence patterns for various cancer sites of NE-India with South and East-Asian regions, which may lead to the conclusion that there might be a genetic linkage between these regions.

Predictors of HIV positivity among pregnant women presenting for obstetric care in South India - a case-control study.

PubMed

Solomon, Eileen; Visnegarwala, Fehmida; Philip, Philimol; Alexander, Glory

2011-10-01

Feminization of the HIV epidemic in India has increasingly burdened the public health infrastructure to provide prevention of mother-to-child transmission (PMTCT) services. A mere 20% of pregnant women in the country receive HIV counseling and testing. One of the strategies, for expansion of PMTCT services is to ascertain an accurate identification of HIV-positive pregnant women. Thus, we sought to characterize a demographic profile of pregnant women at high-risk for HIV infection. We performed a retrospective case-control study. We included as cases, all HIV-positive women identified in a PMTCT program implemented in 23 charitable faith-based hospitals in four states in South India over a period of 75 months, starting in January 2003. Thus a total of 320 HIV-positive cases were frequency matched using stratified random sampling to 365 HIV-negative pregnant women presenting for antenatal care during the same time period. Cases and controls were compared using Chi-square test for categorical variables and Student's t-test for continuous variables. Multivariate step-wise logistic regression analysis was performed. On multivariate analysis, following factors were independently predictive of HIV positivity: age ≤25 years (odds ratio [OR] 0.50; confidence interval [CI] 0.33-0.76; p = 0.001); illiteracy (OR 4.89; CI 2.79-8.57; p <0.0001); woman holding a service and/or professional job (OR 0.27; CI 0.14-0.53; p <0.0001); spouses holding a service or higher job (OR 3.13; CI 2.13-4.59; p <0.0001); being married ≤5 years (OR 2.89; CI 1.68-4.95; p <0.0001); late gestational age at presentation (OR 3.06; CI 2.04-4.59; p <0.0001); history of fetal and/or live born loss (OR 2.36; CI 1.51-3.67; p <0.0001). To our knowledge this is the first large study to evaluate factors predictive of HIV positivity among women presenting for antenatal care in the Indian setting. This type of profiling of HIV-positive pregnant women may help expand PMTCT services in a focused and cost-effective manner in India.

Soft System Methodology as a Tool to Understand Issues of Governmental Affordable Housing Programme of India: A Case Study Approach

NASA Astrophysics Data System (ADS)

Ghosh, Sukanya; Roy, Souvanic; Sanyal, Manas Kumar

2016-09-01

With the help of a case study, the article has explored current practices of implementation of governmental affordable housing programme for urban poor in a slum of India. This work shows that the issues associated with the problems of governmental affordable housing programme has to be addressed to with a suitable methodology as complexities are not only dealing with quantitative data but qualitative data also. The Hard System Methodologies (HSM), which is conventionally applied to address the issues, deals with real and known problems which can be directly solved. Since most of the issues of affordable housing programme as found in the case study are subjective and complex in nature, Soft System Methodology (SSM) has been tried for better representation from subjective points of views. The article explored drawing of Rich Picture as an SSM approach for better understanding and analysing complex issues and constraints of affordable housing programme so that further exploration of the issues is possible.

Designing a Qualitative and Flexible Case Study to Investigate the Opportunities and Challenges for Primary Education Offered to First-Generation Learners in a Rural Community in the State of Maharashtra, India

ERIC Educational Resources Information Center

Velu, Ratika

2015-01-01

Many children from rural communities in India seeking an education are first-generation learners. These children at times find it difficult to cope with the school environment and learning the state language, which is unfamiliar to them. The parents of these children have no academic background or formal education at any level, which leaves them…

Between hype and veracity; privatization of municipal solid waste management and its impacts on the informal waste sector.

PubMed

Sandhu, Kiran; Burton, Paul; Dedekorkut-Howes, Aysin

2017-01-01

The informal waste recycling sector has been an indispensable but ironically invisible part of the waste management systems in developing countries as India, often completely disregarded and overlooked by decision makers and policy frameworks. The turn towards liberalization of economy since 1991 in India opened the doors for privatization of urban services and the waste sector found favor with private companies facilitated by the local governments. In joining the privatization bandwagon, the local governments aim to create an image of a progressive city demonstrated most visibly through apt management of municipal solid waste. Resultantly, the long important stakeholder, the informal sector has been sidelined and left to face the adverse impacts of privatization. There is hardly any recognition of its contributions or any attempt to integrate it within the formal waste management systems. The study investigates the impacts of privatization on the waste pickers in waste recycling operations. Highlighting the other dimension of waste collection and management in urban India the study focuses on the waste pickers and small time informal scrap dealers and this is done by taking the case study of Amritsar city, which is an important historic centre and a metropolitan city in the state of Punjab, India. The paper develops an analytical framework, drawing from literature review to analyze the impacts. In conclusion, it supports the case for involving informal waste sector towards achieving sustainable waste management in the city. Copyright © 2016 Elsevier Ltd. All rights reserved.

Case based measles surveillance in Pune: evidence to guide current and future measles control and elimination efforts in India.

PubMed

Bose, Anindya Sekhar; Jafari, Hamid; Sosler, Stephen; Narula, Arvinder Pal Singh; Kulkarni, V M; Ramamurty, Nalini; Oommen, John; Jadi, Ramesh S; Banpel, R V; Henao-Restrepo, Ana Maria

2014-01-01

According to WHO estimates, 35% of global measles deaths in 2011 occurred in India. In 2013, India committed to a goal of measles elimination by 2020. Laboratory supported case based measles surveillance is an essential component of measles elimination strategies. Results from a case-based measles surveillance system in Pune district (November 2009 through December 2011) are reported here with wider implications for measles elimination efforts in India. Standard protocols were followed for case identification, investigation and classification. Suspected measles cases were confirmed through serology (IgM) or epidemiological linkage or clinical presentation. Data regarding age, sex, vaccination status were collected and annualized incidence rates for measles and rubella cases calculated. Of the 1011 suspected measles cases reported to the surveillance system, 76% were confirmed measles, 6% were confirmed rubella, and 17% were non-measles, non-rubella cases. Of the confirmed measles cases, 95% were less than 15 years of age. Annual measles incidence rate was more than 250 per million persons and nearly half were associated with outbreaks. Thirty-nine per cent of the confirmed measles cases were vaccinated with one dose of measles vaccine (MCV1). Surveillance demonstrated high measles incidence and frequent outbreaks in Pune where MCV1 coverage in infants was above 90%. Results indicate that even high coverage with a single dose of measles vaccine was insufficient to provide population protection and prevent measles outbreaks. An effective measles and rubella surveillance system provides essential information to plan, implement and evaluate measles immunization strategies and monitor progress towards measles elimination.

Case Based Measles Surveillance in Pune: Evidence to Guide Current and Future Measles Control and Elimination Efforts in India

PubMed Central

Bose, Anindya Sekhar; Jafari, Hamid; Sosler, Stephen; Narula, Arvinder Pal Singh; Kulkarni, V. M.; Ramamurty, Nalini; Oommen, John; Jadi, Ramesh S.; Banpel, R. V.; Henao-Restrepo, Ana Maria

2014-01-01

Background According to WHO estimates, 35% of global measles deaths in 2011 occurred in India. In 2013, India committed to a goal of measles elimination by 2020. Laboratory supported case based measles surveillance is an essential component of measles elimination strategies. Results from a case-based measles surveillance system in Pune district (November 2009 through December 2011) are reported here with wider implications for measles elimination efforts in India. Methods Standard protocols were followed for case identification, investigation and classification. Suspected measles cases were confirmed through serology (IgM) or epidemiological linkage or clinical presentation. Data regarding age, sex, vaccination status were collected and annualized incidence rates for measles and rubella cases calculated. Results Of the 1011 suspected measles cases reported to the surveillance system, 76% were confirmed measles, 6% were confirmed rubella, and 17% were non-measles, non-rubella cases. Of the confirmed measles cases, 95% were less than 15 years of age. Annual measles incidence rate was more than 250 per million persons and nearly half were associated with outbreaks. Thirty-nine per cent of the confirmed measles cases were vaccinated with one dose of measles vaccine (MCV1). Conclusion Surveillance demonstrated high measles incidence and frequent outbreaks in Pune where MCV1 coverage in infants was above 90%. Results indicate that even high coverage with a single dose of measles vaccine was insufficient to provide population protection and prevent measles outbreaks. An effective measles and rubella surveillance system provides essential information to plan, implement and evaluate measles immunization strategies and monitor progress towards measles elimination. PMID:25290339

A Case-Study of the Resources and Functioning of Two Research Ethics Committees in Western India.

PubMed

Chenneville, Tiffany; Menezes, Lynette; Kosambiya, Jayendrakumar; Baxi, Rajendra

2016-12-01

Assessing the resources and functioning of research ethics committees (RECs) in low-resource settings poses many challenges. We conducted a case study of two medical college RECs (A and B) in Western India utilizing the Research Ethics Committee Quality Assurance Self-Assessment Tool (RECQASAT) as well as in-depth interviews with representative members to evaluate REC effectiveness. REC A and B obtained 62% and 67% of allowable points on the RECQASAT. These scores together with findings from the in-depth interviews suggest the need for significant improvement in REC effectiveness particularly in the areas of membership and educational training, organizational aspects, recording minutes, communicating decisions, and REC resources. Developing evidence-based best practices and strengthening infrastructure are essential to enhancing REC efficacy in low-resource countries.

Seroprevalence of Burkholderia pseudomallei among Adults in Coastal Areas in Southwestern India

PubMed Central

Vandana, Kalwaje Eshwara; Mukhopadhyay, Chiranjay; Tellapragada, Chaitanya; Kamath, Asha; Tipre, Meghan; Bhat, Vinod; Sathiakumar, Nalini

2016-01-01

Background Although melioidosis, is an important disease in many Southeast Asian countries and Australia, there is limited data on its prevalence and disease burden in India. However, an increase in case reports of melioidosis in recent years indicates its endemicity in India. Aims and methods A population-based cross-sectional seroprevalence study was undertaken to determine the seroprevalence of B. pseudomallei by indirect haemagglutination assay and to investigate the associated risk determinants. Subjects were 711 adults aged 18 to 65 years residing in Udupi district, located in south-western coast of India. Key results Overall, 29% of the study subjects were seropositive (titer ≥20). Females were twice as likely to be seropositive compared to males. Rates of seroprevalence were similar in farmers and non-farmers. Besides gardening, other factors including socio-demographic, occupational and environmental factors did not show any relationship with seropositive status. Major conclusions There is a serological evidence of exposure to B. pseudomallei among adults in India. While the bacterium inhabits soil, exposure to the agent is not limited to farmers. Non-occupational exposure might play an important role in eliciting antibody response to the bacterium and may also be an important factor in disease causation. PMID:27078156

Seroprevalence of Burkholderia pseudomallei among Adults in Coastal Areas in Southwestern India.

PubMed

Vandana, Kalwaje Eshwara; Mukhopadhyay, Chiranjay; Tellapragada, Chaitanya; Kamath, Asha; Tipre, Meghan; Bhat, Vinod; Sathiakumar, Nalini

2016-04-01

Although melioidosis, is an important disease in many Southeast Asian countries and Australia, there is limited data on its prevalence and disease burden in India. However, an increase in case reports of melioidosis in recent years indicates its endemicity in India. A population-based cross-sectional seroprevalence study was undertaken to determine the seroprevalence of B. pseudomallei by indirect haemagglutination assay and to investigate the associated risk determinants. Subjects were 711 adults aged 18 to 65 years residing in Udupi district, located in south-western coast of India. Overall, 29% of the study subjects were seropositive (titer ≥20). Females were twice as likely to be seropositive compared to males. Rates of seroprevalence were similar in farmers and non-farmers. Besides gardening, other factors including socio-demographic, occupational and environmental factors did not show any relationship with seropositive status. There is a serological evidence of exposure to B. pseudomallei among adults in India. While the bacterium inhabits soil, exposure to the agent is not limited to farmers. Non-occupational exposure might play an important role in eliciting antibody response to the bacterium and may also be an important factor in disease causation.

Identification of different lineages of measles virus strains circulating in Uttar Pradesh, North India.

PubMed

Shakya, Akhalesh Kumar; Shukla, Vibha; Maan, Harjeet Singh; Dhole, Tapan N

2012-10-16

Genetic analysis of measles viruses associated with recent cases and outbreaks has proven to bridge information gaps in routine outbreak investigations and has made a substantial contribution to measles control efforts by helping to identify the transmission pathways of the virus. The present study describes the genetic characterization of wild type measles viruses from Uttar Pradesh, India isolated between January 2008 and January 2011. In the study, 526 suspected measles cases from 15 outbreaks were investigated. Blood samples were collected from suspected measles outbreaks and tested for the presence of measles specific IgM; throat swab and urine samples were collected for virus isolation and RT-PCR. Genotyping of circulating measles viruses in Uttar Pradesh was performed by sequencing a 450-bp region encompassing the nucleoprotein hypervariable region and phylogenetic analysis. Based on serological results, all the outbreaks were confirmed as measles. Thirty eight strains were obtained. Genetic analysis of circulating measles strains (n = 38) in Uttar Pradesh from 235 cases of laboratory-confirmed cases from 526 suspected measles cases between 2008 and 2011 showed that all viruses responsible for outbreaks were within clade D and all were genotype D8.Analysis of this region showed that it is highly divergent (up to 3.4% divergence in the nucleotide sequence and 4.1% divergence in the amino acid sequence between most distant strains). Considerable genetic heterogeneity was observed in the MV genotype D8 viruses in North India and underscores the need for continued surveillance and in particular increases in vaccination levels to decrease morbidity and mortality attributable to measles.

Divergent Perspectives and Differing Logics: The Case for Affirmative Action in India

ERIC Educational Resources Information Center

Rout, Bharat Chandra

2012-01-01

Affirmative action (AA) is one of the most suitable mechanisms to promote equity and social justice in education in India. This essay deals with the impact of the different conceptualizations of AA in terms of its vision and the historic approaches to social inequalities in India. Primarily focusing on the various perspectives of affirmative…

HIV-Related Knowledge and Attitudes among First Year Medical Students in Mumbai, India Adolescents

ERIC Educational Resources Information Center

Samant, Yogindra; Mankeshwar, Ranjit; Sankhe, Lalit; Parker, David L.

2006-01-01

Background: The total number of people with HIV (Human Immunodeficiency Virus) infection in India is estimated to be 10% of all global cases. People living with HIV in India often experience discrimination while receiving health care due to inadequate knowledge and fear among health care professionals. Data presented in this paper represents the…

Analysis of crimes committed against scheduled tribes

NASA Astrophysics Data System (ADS)

Khadse, Vivek P.; Akhil, P.; Anto, Christopher; Gnanasigamani, Lydia J.

2017-11-01

One of the curses to the society is a crime which has a deep impact on the society. Victims of crimes are the one who is impacted the most. All communities in the world are affected by crime and the criminal justice system, but largely impacted communities are the backward classes. There are many cases reported of crime committed against scheduled tribes from the year 2005 till date. This paper states the analysis of Crimes Committed against Scheduled Tribes in the year 2015 in various states and union territories in India. In this study, Multiple Linear regression techniques have been used to analyze the crimes committed against scheduled tribes’ community in India. This study compares the number of cases reported to the police station and rate of crime committed in different states in India. It also states the future prediction of the crime that would happen. It will also predict the number of cases of crime committed against the scheduled tribe that can be reported in future. The dataset which has been used in this study is taken from official Indian government repository for crimes which include different information of crimes committed against scheduled tribes in different states and union territories measured under the population census of the year 2011. This study will help different Indian states and union territory government to analyze and predict the future crimes that may occur and take appropriate measures against it before the actual crime would occur.

Use of Xpert MTB/RIF in Decentralized Public Health Settings and Its Effect on Pulmonary TB and DR-TB Case Finding in India.

PubMed

Sachdeva, Kuldeep Singh; Raizada, Neeraj; Sreenivas, Achuthan; Van't Hoog, Anna H; van den Hof, Susan; Dewan, Puneet K; Thakur, Rahul; Gupta, R S; Kulsange, Shubhangi; Vadera, Bhavin; Babre, Ameet; Gray, Christen; Parmar, Malik; Ghedia, Mayank; Ramachandran, Ranjani; Alavadi, Umesh; Arinaminpathy, Nimalan; Denkinger, Claudia; Boehme, Catharina; Paramasivan, C N

2015-01-01

Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India. This demonstration study was implemented in 18 sub-district level TB programme units (TUs) in India in diverse geographic and demographic settings covering a population of 8.8 million. A baseline phase in 14 TUs captured programmatic baseline data, and an intervention phase in 18 TUs had Xpert MTB/RIF offered to all presumptive TB patients. We estimated changes in detection of TB and DR-TB, the former using binomial regression models to adjust for clustering and covariates. In the 14 study TUs, which participated in both phases, 10,675 and 70,556 presumptive TB patients were enrolled in the baseline and intervention phase, respectively, and 1,532 (14.4%) and 14,299 (20.3%) bacteriologically confirmed PTB cases were detected. The implementation of Xpert MTB/RIF was associated with increases in both notification rates of bacteriologically confirmed TB cases (adjusted incidence rate ratio [aIRR] 1.39; CI 1.18-1.64), and proportion of bacteriological confirmed TB cases among presumptive TB cases (adjusted risk ratio (aRR) 1.33; CI 1.6-1.52). Compared with the baseline strategy of selective drug-susceptibility testing only for PTB cases at high risk of drug-resistant TB, Xpert MTB/RIF implementation increased rifampicin resistant TB case detection by over fivefold. Among, 2765 rifampicin resistance cases detected, 1055 were retested with conventional drug susceptibility testing (DST). Positive predictive value (PPV) of rifampicin resistance detected by Xpert MTB/RIF was 94.7% (CI 91.3-98.1), in comparison to conventional DST. Introduction of Xpert MTB/RIF as initial diagnostic test for TB in public health facilities significantly increased case-notification rates of all bacteriologically confirmed TB by 39% and rifampicin-resistant TB case notification by fivefold.

Use of Xpert MTB/RIF in Decentralized Public Health Settings and Its Effect on Pulmonary TB and DR-TB Case Finding in India

PubMed Central

Sachdeva, Kuldeep Singh; Raizada, Neeraj; Sreenivas, Achuthan; van't Hoog, Anna H.; van den Hof, Susan; Dewan, Puneet K.; Thakur, Rahul; Gupta, R. S.; Kulsange, Shubhangi; Vadera, Bhavin; Babre, Ameet; Gray, Christen; Parmar, Malik; Ghedia, Mayank; Ramachandran, Ranjani; Alavadi, Umesh; Arinaminpathy, Nimalan; Denkinger, Claudia; Boehme, Catharina; Paramasivan, C. N.

2015-01-01

Background Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India. Methods This demonstration study was implemented in 18 sub-district level TB programme units (TUs) in India in diverse geographic and demographic settings covering a population of 8.8 million. A baseline phase in 14 TUs captured programmatic baseline data, and an intervention phase in 18 TUs had Xpert MTB/RIF offered to all presumptive TB patients. We estimated changes in detection of TB and DR-TB, the former using binomial regression models to adjust for clustering and covariates. Results In the 14 study TUs, which participated in both phases, 10,675 and 70,556 presumptive TB patients were enrolled in the baseline and intervention phase, respectively, and 1,532 (14.4%) and 14,299 (20.3%) bacteriologically confirmed PTB cases were detected. The implementation of Xpert MTB/RIF was associated with increases in both notification rates of bacteriologically confirmed TB cases (adjusted incidence rate ratio [aIRR] 1.39; CI 1.18-1.64), and proportion of bacteriological confirmed TB cases among presumptive TB cases (adjusted risk ratio (aRR) 1.33; CI 1.6-1.52). Compared with the baseline strategy of selective drug-susceptibility testing only for PTB cases at high risk of drug-resistant TB, Xpert MTB/RIF implementation increased rifampicin resistant TB case detection by over fivefold. Among, 2765 rifampicin resistance cases detected, 1055 were retested with conventional drug susceptibility testing (DST). Positive predictive value (PPV) of rifampicin resistance detected by Xpert MTB/RIF was 94.7% (CI 91.3-98.1), in comparison to conventional DST. Conclusion Introduction of Xpert MTB/RIF as initial diagnostic test for TB in public health facilities significantly increased case-notification rates of all bacteriologically confirmed TB by 39% and rifampicin-resistant TB case notification by fivefold. PMID:25996389

The lost hope of elimination of Kala-azar (visceral leishmaniasis) by 2010 and cyclic occurrence of its outbreak in India, blame falls on vector control practices or co-infection with human immunodeficiency virus or therapeutic modalities?

PubMed

Muniaraj, Mayilsamy

2014-01-01

The Kala-azar/visceral leishmaniasis (VL) turns epidemic form once in every 15 years in the endemic regions of Indian subcontinent. The goal of elimination of Kala-azar from India by 2010 was lost despite paramount efforts taken by the Government of India and World Health Organization and Regional Office for South East Asia. The main objective of this review was to elucidate the possible reason for the failure of Kala-azar elimination program and to suggest possible remedial measures to achieve the goal in future. The annual numbers of VL cases and deaths recorded in India since 1977 were plotted on a graph, to see if the temporal trends could be associated with changes in the vector control practices or co-infection with human immunodeficiency virus (HIV) or therapeutic modalities used against VL. The VL cases flares up whenever the effect of dichlorodiphenyltrichloroethane (DDT) diminished after the withdrawal of spray. The fading effectiveness was clearly correlated with an increasing number of VL cases. Therapeutic modalities were found to be highly correlating with VL mortality not with VL morbidity. The diminishing efficacy of first and second line drugs and the introduction of new drugs and drugs combination were responsible for ups and downs in the VL mortality. The VL mortality is constantly declining since 1993, but cases started increasing from 2003 to 2007 and then recently again from 2010 to 2011. This shows a serious lacuna in the vector control practices applied. The extent of HIV co-infection did not show any correlation with number/trend of VL cases or death over the study period. It is concluded that, by strict vector control practices, the VL cases can be reduced and by applying proper therapeutic strategies, the VL mortality can be reduced. HIV-VL co-infection does not seem to be in a worried stage.

Progress toward poliomyelitis eradication--India, January 2004-May 2005.

PubMed

2005-07-08

Since 1988, the global incidence of polio has decreased by more than 99%, and three World Health Organization (WHO) regions (Americas, Western Pacific, and European) have been certified as polio-free . India, the largest of the six countries where polio remains endemic, experienced a large polio outbreak (1,600 cases) in 2002. Since then, the Government of India (GOI) has accelerated its polio eradication activities by increasing the number and quality of supplementary immunization activities (SIAs), which reduced the number of reported cases to 225 in 2003, 134 in 2004, and 18 in 2005 (as of June 18). During 2004 and early 2005, taking advantage of the geographic restriction of wild poliovirus (WPV) circulation, GOI and its partners launched several immunization and surveillance strategies to maximize the probability of eliminating poliovirus transmission in India. With continued high-quality interventions, interruption of WPV transmission in India by the end of 2005 appears feasible. This report summarizes progress toward polio elimination during January 2004-May 2005 toward that end.

Case studies of innovative medical device companies from India: barriers and enablers to development

PubMed Central

2013-01-01

Background Over 75% of the medical devices used in India are imported. Often, they are costly and maladapted to low-resource settings. We have prepared case studies of six firms in Bangalore that could contribute to solving this problem. They have developed (or are developing) innovative health care products and therefore are pioneers in the Indian health care sector, better known for its reverse engineering skills. We have sought to understand what enablers and barriers they encountered. Methods Information for the case studies was collected through semi-structured interviews. Initially, over 40 stakeholders of the diagnostics sector in India were interviewed to understand the sector. However the focus here is on the six featured companies. Further information was obtained from company material and other published resources. Results In all cases, product innovation has been enabled by close interaction with local medical practitioners, links to global science and technology and global regulatory requirements. The major challenges were the lack of guidance on product specifications from the national regulatory agency, paucity of institutionalized health care payers and lack of transparency and formalized Health Technology Assessment in coverage decision-making. The absence of national evidence-based guidelines and of compulsory continuous education for medical practitioners were key obstacles in accessing the poorly regulated and fragmented private market. Conclusions Innovative Indian companies would benefit from a strengthened capacity and interdisciplinary work culture of the national device regulatory body, institutionalized health care payers and medical councils and associations. Continuous medical education and national medical guidelines for medical practitioners would facilitate market access for innovative products. PMID:23721110

Retrospective analysis of clinical information in Crimean-Congo haemorrhagic fever patients: 2014-2015, India

PubMed Central

Mourya, Devendra T.; Viswanathan, Rajlakshmi; Jadhav, Santosh Kumar; Yadav, Pragya D.; Basu, Atanu; Chadha, Mandeep S.

2017-01-01

Background & objectives: Differential diagnosis of Crimean-Congo haemorrhagic fever (CCHF) from other acute febrile illnesses with haemorrhagic manifestation is challenging in India. Nosocomial infection is a significant mode of transmission due to exposure of healthcare workers to blood and body fluids of infected patients. Being a risk group 4 virus, laboratory confirmation of infection is not widely available. In such a situation, early identification of potential CCHF patients would be useful in limiting the spread of the disease. The objective of this study was to retrospectively analyse clinical and laboratory findings of CCHF patients that might be useful in early detection of a CCHF case in limited resource settings. Methods: Retrospective analysis of clinical and laboratory data of patients suspected to have CCHF referred for diagnosis from Gujarat and Rajasthan States of India (2014-2015) was done. Samples were tested using CCHF-specific real time reverse transcription (RT)-PCR and IgM ELISA. Results: Among the 69 patients referred, 21 were laboratory confirmed CCHF cases of whom nine had a history of occupational exposure. No clustering of cases was noted. Platelet count cut-off for detection of positive cases by receiver operating characteristic curve was 21.5×10[9]/l with sensitivity 82.4 per cent and specificity 82.1 per cent. Melaena was a significant clinical presentation in confirmed positive CCHF patients. Interpretation & conclusions: The study findings suggest that in endemic areas thrombocytopenia and melaena may be early indicators of CCHF. Further studies are needed to confirm these findings. PMID:28948959

Case studies of innovative medical device companies from India: barriers and enablers to development.

PubMed

Jarosławski, Szymon; Saberwal, Gayatri

2013-05-30

Over 75% of the medical devices used in India are imported. Often, they are costly and maladapted to low-resource settings. We have prepared case studies of six firms in Bangalore that could contribute to solving this problem. They have developed (or are developing) innovative health care products and therefore are pioneers in the Indian health care sector, better known for its reverse engineering skills. We have sought to understand what enablers and barriers they encountered. Information for the case studies was collected through semi-structured interviews. Initially, over 40 stakeholders of the diagnostics sector in India were interviewed to understand the sector. However the focus here is on the six featured companies. Further information was obtained from company material and other published resources. In all cases, product innovation has been enabled by close interaction with local medical practitioners, links to global science and technology and global regulatory requirements. The major challenges were the lack of guidance on product specifications from the national regulatory agency, paucity of institutionalized health care payers and lack of transparency and formalized Health Technology Assessment in coverage decision-making. The absence of national evidence-based guidelines and of compulsory continuous education for medical practitioners were key obstacles in accessing the poorly regulated and fragmented private market. Innovative Indian companies would benefit from a strengthened capacity and interdisciplinary work culture of the national device regulatory body, institutionalized health care payers and medical councils and associations. Continuous medical education and national medical guidelines for medical practitioners would facilitate market access for innovative products.

Pathology and polymerase chain reaction detection of ovine progressive pneumonia (maedi) cases in slaughtered sheep in India

PubMed Central

Singh, Rahul; Kumar, Pawan; Singh, Rajendra; Dhama, Kuldeep; Kumari, Swati; Yadav, Jay Prakash; Kashyap, Gayatri; Singh, Karam Pal; Singh, Vidya; Sahoo, Monalisa

2017-01-01

Aim: The small ruminant lentiviruses are known to cause maedi-visna (MV) and caprine arthritis - encephalitis in sheep and goats, typically affecting joints, udder, lungs, and the central nervous system. The diagnosis usually involves serology, clinical signs, immunohistochemistry, and polymerase chain reaction (PCR). In the present study, the histopathologically positive pneumonia cases of MV were confirmed by PCR in lung tissue probably for the first time in India. Materials and Methods: A total of 888 lungs of adult sheep, aged between 2 and 5 years, were screened during slaughter, of which 121 were found to have pneumonic lesions. The tissues from each pneumonic lung including associated lymph nodes were collected in 10% neutral buffered formalin for histopathology. The frozen tissues of the same were also collected and stored at −20°C for PCR confirmation. Results: Three of 121 cases of pneumonic lungs of sheep revealed gross and histopathological lesions suggestive of maedi or ovine progressive pneumonia infection. These 3 cases were further confirmed by PCR technique that amplified 291-base pair DNA in the long terminal repeat sequence of MV provirus. Conclusion: This study suggests the low occurrence of MV virus (MVV) infection in India in naturally affected sheep based on pathomorphological lesions and using the molecular tool of PCR detection of the virus in tissues. Further, a combination of pathomorphology or/and PCR testing might be optimal for detecting the animals infected with MVV. PMID:29263606

Evaluation of chikungunya virus infection in children from India during 2009-2010: A cross sectional observational study.

PubMed

Raghavendhar, B Siva; Ray, Pratima; Ratagiri, Vinod H; Sharma, B S; Kabra, Sushil K; Lodha, Rakesh

2016-06-01

Chikungunya virus, a small (about 60-70 nm diameter), spherical, enveloped, positive, single stranded RNA virus is transmitted by Aedes mosquitoes. After a short period of incubation (3-5 days) symptoms like fever with joint pains and others start appearing. After a gap of 20 years, this virus re-emerged during 2006-2008 in India causing a major outbreak of CHIKV in India. This study was conducted subsequent to the major outbreak in order to evaluate the proportion of chikungunya virus infection in children with suggestive symptoms at three geographical locations of India. Lineage of circulating strains and changes in the E1 structural polypeptide were also determined. Blood samples were collected (in Sodium citrate vacutainer tubes) during 1st June 2009 to 31st May 2010 from children (age 0 ≤ 18 years) suspected to have chikungunya infection, that is, those who presented with sudden onset of fever and/or joint pain, myalgia, and headache from three regions of India, All India Institute of Medical Sciences (AIIMS) in New Delhi, Karnataka Institute of Medical Sciences (KIMS) in Hubli and Sawai Mansingh Medical College (SMS) in Jaipur. Detection of CHIKV antibodies in all acute-phase patient plasma samples was done by IgM ELISA and for samples within ≤5 days of fever, a one-step RT-PCR was carried out on a block thermo-cycler targeting 294 bp region of E1 gene that codes for the viral envelope protein. Comparison of nucleotide and amino acid sequences from few positive samples of two regions was done with African S-27 reference strain using BioEdit. A phylogenetic tree was constructed using MEGA 6 by using the Maximum Likelihood method based on the Kimura 2-parameter model. Out of the 723 acute phase samples tested from three geographical locations of India, Chikungunya virus infection was detected in 249/723 (34.44%) subjects by either IgM Elisa (180/723) or RT-PCR (69/412). RT-PCR was employed in samples collected from children with ≤5 days of fever. Maximum positive cases were from KIMS center, Hubli. Seasonally, positivity varied with number of enrolled cases at KIMS and SMS. Joint pain was significantly associated with CHIKV positivity (P = 0.0156). Presence/absence of certain clinical features varied with age (P < 0.05). Sequence analysis revealed four amino acid changes. Phylogenetic analysis with partial sequences of E1 gene from KIMS (n = 12) and SMS (n = 5) showed that the study isolates clustered with Indian Ocean Lineage strains (IOL) of East, Central and South African (ECSA) type. Evaluation of chikungunya virus infection in children from India during 2009-2010 showed high proportion of CHIKV infection in Southern region of India compared to Northern region. The circulating CHIKV strains were of Indian Ocean Lineage (IOL) group within the East, Central, and South African (ECSA) genotype. However few amino acid changes were observed in E1 polypeptide with reference to African strain S-27 (AF369024). Further studies are needed to know the implications of these changes in vector-pathogen compatibility and host-pathogen interactivity. As a whole, this study highlighted the proportion of CHIKV cases, lineage of causative strain and evolutionary pattern of circulating strain in terms of amino acid changes in the structural protein. © 2015 Wiley Periodicals, Inc.

Characterizing measles transmission in India: a dynamic modeling study using verbal autopsy data.

PubMed

Verguet, Stéphane; Jones, Edward O; Johri, Mira; Morris, Shaun K; Suraweera, Wilson; Gauvreau, Cindy L; Jha, Prabhat; Jit, Mark

2017-08-10

Decreasing trends in measles mortality have been reported in recent years. However, such estimates of measles mortality have depended heavily on assumed regional measles case fatality risks (CFRs) and made little use of mortality data from low- and middle-income countries in general and India, the country with the highest measles burden globally, in particular. We constructed a dynamic model of measles transmission in India with parameters that were empirically inferred using spectral analysis from a time series of measles mortality extracted from the Million Death Study, an ongoing longitudinal study recording deaths across 2.4 million Indian households and attributing causes of death using verbal autopsy. The model was then used to estimate the measles CFR, the number of measles deaths, and the impact of vaccination in 2000-2015 among under-five children in India and in the states of Bihar and Uttar Pradesh (UP), two states with large populations and the highest numbers of measles deaths in India. We obtained the following estimated CFRs among under-five children for the year 2005: 0.63% (95% confidence interval (CI): 0.40-1.00%) for India as a whole, 0.62% (0.38-1.00%) for Bihar, and 1.19% (0.80-1.75%) for UP. During 2000-2015, we estimated that 607,000 (95% CI: 383,000-958,000) under-five deaths attributed to measles occurred in India as a whole. If no routine vaccination or supplemental immunization activities had occurred from 2000 to 2015, an additional 1.6 (1.0-2.6) million deaths for under-five children would have occurred across India. We developed a data- and model-driven estimation of the historical measles dynamics, CFR, and vaccination impact in India, extracting the periodicity of epidemics using spectral and coherence analysis, which allowed us to infer key parameters driving measles transmission dynamics and mortality.

Profile of Home-based Caregivers of Bedridden Patients in North India.

PubMed

Bains, Puneet; Minhas, Amarjeet Singh

2011-04-01

Caregiving to bedridden patients in India is set to become a major problem in future. To ascertain the profile of caregivers for the adult bedridden patients in Chandigarh, India. This cross-sectional study was conducted on 100 purposively selected bedridden people. The Katz Index of the activities of daily living was used to ascertain their degree of disability. Patients and families were interviewed about the patterns of care provision. The mean age of subjects was 69 years. A majority (68%) of them lived in joint families. All of them required assistance in bathing, dressing, toileting, and transfer. In 54% of the cases someone was hired to look after the subjects. A majority of the caregivers (82%) were family members. All caregivers were untrained. In 35% of the cases unqualified practitioners were consulted, while in 59% of the cases government hospitals were consulted. Most patients (78) were given medicines on time. Complications like urinary tract infection (39%) and pressure ulcers (54%) were reported; 57% of the patients reported satisfaction with the care provided. The main source of caregivers for the bedridden was the family. Bedridden people had high rates of medical complications. There is a need for formal training for the caregivers.

Estimating tuberculosis incidence from primary survey data: a mathematical modeling approach.

PubMed

Pandey, S; Chadha, V K; Laxminarayan, R; Arinaminpathy, N

2017-04-01

There is an urgent need for improved estimations of the burden of tuberculosis (TB). To develop a new quantitative method based on mathematical modelling, and to demonstrate its application to TB in India. We developed a simple model of TB transmission dynamics to estimate the annual incidence of TB disease from the annual risk of tuberculous infection and prevalence of smear-positive TB. We first compared model estimates for annual infections per smear-positive TB case using previous empirical estimates from China, Korea and the Philippines. We then applied the model to estimate TB incidence in India, stratified by urban and rural settings. Study model estimates show agreement with previous empirical estimates. Applied to India, the model suggests an annual incidence of smear-positive TB of 89.8 per 100 000 population (95%CI 56.8-156.3). Results show differences in urban and rural TB: while an urban TB case infects more individuals per year, a rural TB case remains infectious for appreciably longer, suggesting the need for interventions tailored to these different settings. Simple models of TB transmission, in conjunction with necessary data, can offer approaches to burden estimation that complement those currently being used.

Awareness of HIV results in increased condom sales.

PubMed

1994-12-19

India's government reports a campaign against HIV increased condom sales by 4% in 1994. New Delhi reported a sale of more than 1 billion condoms in 1993-94 after a sharp decline of 8% in 1993, the Times of India said. Increasing awareness of HIV accounted for the growth in the condom market, said an official of Hindustan Latex Ltd. "Men in India do not use condoms for contraception," the company's executive director Daolly Frances said. "They leave that burden to women." The total market sale of condoms for 1994 was 1.1 billion items, almost the same number distributed free of charge under the government's family welfare program. "It is encouraging but still far below the market potential," the chairman of the condom-making company said. The WHO (World Health Organization) has identified India as one of the countries that will witness the greatest explosion of HIV cases in the coming years. According to WHO figures, incidence of HIV in Asia has increased 5 times in the last 3 years from 0.5 million in 1991 to more than 2.5 million cases at present. "The figure is expected to quadruple by the year 2000 to over ten million infections," regional director of WHO for Southeast Asia Uton Muchtar Rafei said on the World AIDS Day December 1, 1994. Official records say there are 885 full-blown AIDS cases in India, with 1.6 million people testing positive for HIV. But non-government organizations place the figure much higher. India's Health Organization said India will have up to 30 million HIV cases by the year 2000. "The epidemic has now moved from sex workers and their clients to housewives and newborn babies," said I.S. Gilhada, secretary-general of Indian Health Organization. A government survey among Bombay's sex workers has shown 52% tested positive for HIV. Despite a $100 million World Bank-WHO funded AIDS control program, reports suggest a gross misuse of government's free condoms distribution scheme. full text

Should chemoprophylaxis be a main strategy for preventing re-introduction of malaria in highly receptive areas? Sri Lanka a case in point.

PubMed

Wickremasinghe, A Rajitha; Wickremasinghe, Renu; Herath, Hemantha D B; Fernando, S Deepika

2017-03-04

Imported malaria cases continue to be reported in Sri Lanka, which was declared 'malaria-free' by the World Health Organization in September 2016. Chemoprophylaxis, a recommended strategy for malaria prevention for visitors travelling to malaria-endemic countries from Sri Lanka is available free of charge. The strategy of providing chemoprophylaxis to visitors to a neighbouring malaria-endemic country within the perspective of a country that has successfully eliminated malaria but is highly receptive was assessed, taking Sri Lanka as a case in point. The risk of a Sri Lankan national acquiring malaria during a visit to India, a malaria-endemic country, was calculated for the period 2008-2013. The cost of providing prophylaxis for Sri Lankan nationals travelling to India for 1, 2 and 4 weeks was estimated for that same period. The risk of a Sri Lankan traveller to India acquiring malaria ranged from 5.25 per 100,000 travellers in 2012 to 13.45 per 100,000 travellers in 2010. If 50% of cases were missed by the Sri Lankan healthcare system, then the risk of acquiring malaria in India among returning Sri Lankans would double. The 95% confidence intervals for both risks are small. As chloroquine is the chemoprophylactic drug recommended for travellers to India by the Anti Malaria Campaign of Sri Lanka, the costs of chemoprophylaxis for travellers for a 1-, 2- and 4-weeks stay in India on average are US$ 41,604, 48,538 and 62,407, respectively. If all Sri Lankan travellers to India are provided with chemoprophylaxis for four weeks, it will comprise 0.65% of the national malaria control programme budget. Based on the low risk of acquiring malaria among Sri Lankan travellers returning from India and the high receptivity in previously malarious areas of the country, chemoprophylaxis should not be considered a major strategy in the prevention of re-introduction. In areas with high receptivity, universal access to quality-assured diagnosis and treatment cannot be compromised at whatever cost.

Cases of human fascioliasis in India: tip of the iceberg.

PubMed

Ramachandran, J; Ajjampur, S S R; Chandramohan, A; Varghese, G M

2012-01-01

This report presents two cases of human fascioliasis from different states in India. Although only few cases of human fascioliasis have been reported from India previously, both these cases were encountered within a span of three months at this tertiary care centre. Case 1 had significant symptoms with episodes of fever, abdominal pain and eosiniphilia and underwent multiple diagnostic procedures before the correct diagnosis was reached. Case 2, who had few symptoms, had fascioliasis diagnosed with minimal evaluation. These different presentations seen at two ends of the clinical spectrum of disease along with findings of peripheral eosinophilia, and radiological findings led to a presumptive diagnosis that was then confirmed by microscopic examination of bile. Morphometric analysis of ova from these cases was suggestive of infestation with F. gigantica or a F. gigantica-like hybrid. Both patients were treated with triclabendazole which was imported from Geneva. The need to be aware of the possibility of occurrence of this disease and the inclusion of drugs used for treating the disease, in the Indian drug list, should be emphasized.

Cost-effectiveness of Haemophilus influenzae type b (Hib) vaccine introduction in the universal immunization schedule in Haryana State, India.

PubMed

Gupta, Madhu; Prinja, Shankar; Kumar, Rajesh; Kaur, Manmeet

2013-01-01

In India, Haemophilus influenzae type b (Hib) vaccine introduction in the universal immunization programme requires evidence of its potential health impact and cost-effectiveness, as it is a costly vaccine. Since childhood mortality, vaccination coverage and health service utilization vary across states, the cost-effectiveness of introducing Hib vaccine was studied in Haryana state. A mathematical model was used to compare scenarios with and without Hib vaccination to estimate the cost-effectiveness of Hib vaccine in Haryana from 2010 to 2024. Demographic and National Family Health Surveys were used to estimate vaccination coverage and mortality rates among children under 5. Hib pneumonia, Hib meningitis and invasive Hib disease incidence were based on Indian studies. Vaccine and syringe prices of the UNICEF supply division were used. Cost-effectiveness from government and societal perspectives was calculated as the net incremental cost per unit of health benefit gained [disability-adjusted life years (DALYs) averted, life years saved, Hib cases averted, Hib deaths averted]. Sensitivity analysis was done using variation in parameter estimates among different states of India. The incremental cost of Hib vaccine introduction from a government and a societal perspective was estimated to be US$81.4 and US$27.5 million, respectively, from 2010 to 2024. Vaccination of 73.3, 71.6 and 67.4 million children with first, second and third dose of pentavalent vaccine, respectively, would avert 7 067 817 cases, 31 331 deaths and 994 564 DALYs. Incremental cost per DALY averted from a government (US$819) and a societal perspective (US$277) was found to be less than the per capita gross national income of India in 2009. In sensitivity analysis, Hib vaccine introduction remained cost-effective for India. Hib vaccine introduction is a cost-effective strategy in India.

Unusual presentation of Enterobius vermicularis in conjunctival sac.

PubMed

Mallick, Sanjay Kumar; Sengupta, Ranadeep; Banerjee, Arup Kumar

2015-10-01

We report an unusual case of extraintestinal infection with adult Enterobius vermicularis worms in the conjunctival sac of a two-and-a-half year old boy from Alipurduar, West Bengal, India. Only two other similar cases have been reported in the English literature, one from Assam, India in 1976, and the other from Illinois and California in 2011. © The Author(s) 2014.

Guillain–Barré Syndrome in India: Population-based validation of the Brighton criteria

PubMed Central

Mateen, Farrah J.; Cornblath, David R.; Jafari, Hamid; Shinohara, Russell T.; Khandit, Devendra; Ahuja, Bina; Bahl, Sunil; Sutter, Roland W.

2013-01-01

Objective Case definitions of GBS were recently developed in response to the 2009 H1N1 vaccination programme but have undergone limited field testing. We validate the sensitivity of the Brighton Working Group case definitions for Guillain–Barré Syndrome (GBS) using a population-based cohort in India. Methods The National Polio Surveillance Unit of India actively collects all cases of acute flaccid paralysis (AFP) in children <15 years old, including cases of GBS. Cases of GBS with available cerebrospinal fluid(CSF) and nerve conduction studies (NCS) results, neurological examination, clinical history, and exclusion of related diagnoses were selected (2002–2003). Relevant data were abstracted and entered into a central database. Sensitivity of the Brighton GBS criteria for level 3 of diagnostic certainty which requires no clinical laboratory testing, level 2 which employs CSF or NCS, and level 1 which employs both, were calculated. Results 79 cases of GBS (mean age 6.5 years, range 4.0–14.5; 39% female) met the case definition. GBS cases were ascending (79%), symmetrical (85%), and bilateral (100%); involving lower extremity hypotonia (86%) and weakness (100%), upper extremity hypotonia (62%) and weakness (80%), areflexia/hyporeflexia (88%), respiratory muscles (22%), bulbar muscles (22%), and cranial nerves (13%). Four limbs were involved in 80% of cases. Mean time to maximal weakness was 5.2 days (range 0.5–30 days) with nadir GBS disability scores of 3 (7%), 4 (67%), 5 (15%), 6 (10%), or unclear (1%). CSF (mean time to lumbar puncture 29 days) was normal in 29% with cytoalbuminologic dissociation in 65% (mean protein 105 mg/dL, range 10–1000; mean cell count 11/μL, range 0–220, n = 4 with >50 cells/μL). Significant improvement occurred in 73% whereas death (9%) occurred 6–29 days after sensorimotor symptom onset. The majority of cases (86%) fulfilled Brighton level 3, level 2 (84%), and level 1 (62%) of diagnostic certainty. Conclusion The diagnosis of GBS can be made using Brighton Working Group criteria in India with moderate to high sensitivity. Brighton Working Group case definitions are a plausible standard for capturing a majority of cases of GBS in field operations in low income settings during AFP surveillance. PMID:22001121

Spinocerebellar ataxia type 6 in eastern India: Some new observations.

PubMed

Bhattacharyya, Kalyan B; Pulai, Debabrata; Guin, Deb Shankar; Ganguly, Goutam; Joardar, Anindita; Roy, Sarnava; Rai, Saurabh; Biswas, Atanu; Pandit, Alok; Roy, Arijit; Senapati, Asit Kumar

2016-01-01

Spinocerebellar ataxias (SCAs) are hereditary, autosomal dominant progressive neurodegenerative disorders showing clinical and genetic heterogeneity. They are usually manifested clinically in the third to fifth decade of life although there is a wide variability in the age of onset. More than 36 different types of SCAs have been reported so far and about half of them are caused by pathological expansion of the trinucleotide, Cytosine Alanine Guanine (CAG) repeat. The global prevalence of SCA is 0.3-2 per 100,000 population, SCA3 being the commonest variety worldwide, accounting for 20-50 per cent of all cases, though SCA 2 is generally considered as the commonest one in India. However, SCA6 has not been addressed adequately from India though it is common in the eastern Asian countries like, Japan, Korea and Thailand. The present study was undertaken to identify the prevalence of SCA6 in the city of Kolkata and the eastern part of India. 83 consecutive patients were recruited for the study of possible SCAs and their clinical features and genotype were investigated. 6 of the 83 subjects turned out positive for SCA6, constituting therefore, 13.33% of the patient pool. SCA6 is prevalent in the eastern part of India, though not as frequent as the other common varieties. Further community based studies are required in order to understand the magnitude of SCA6 in the eastern part, as well as in other regions of India.

Multi-center feasibility study evaluating recruitment, variability in risk factors and biomarkers for a diet and cancer cohort in India

PubMed Central

2011-01-01

Background India's population exhibits diverse dietary habits and chronic disease patterns. Nutritional epidemiologic studies in India are primarily of cross-sectional or case-control design and subject to biases, including differential recall of past diet. The aim of this feasibility study was to evaluate whether a diet-focused cohort study of cancer could be established in India, providing insight into potentially unique diet and lifestyle exposures. Methods Field staff contacted 7,064 households within three regions of India (New Delhi, Mumbai, and Trivandrum) and found 4,671 eligible adults aged 35-69 years. Participants completed interviewer-administered questionnaires (demographic, diet history, physical activity, medical/reproductive history, tobacco/alcohol use, and occupational history), and staff collected biological samples (blood, urine, and toenail clippings), anthropometric measurements (weight, standing and sitting height; waist, hip, and thigh circumference; triceps, sub-scapula and supra-patella skin fold), and blood pressure measurements. Results Eighty-eight percent of eligible subjects completed all questionnaires and 67% provided biological samples. Unique protein sources by region were fish in Trivandrum, dairy in New Delhi, and pulses (legumes) in Mumbai. Consumption of meat, alcohol, fast food, and soft drinks was scarce in all three regions. A large percentage of the participants were centrally obese and had elevated blood glucose levels. New Delhi participants were also the least physically active and had elevated lipids levels, suggesting a high prevalence of metabolic syndrome. Conclusions A high percentage of participants complied with study procedures including biological sample collection. Epidemiologic expertise and sufficient infrastructure exists at these three sites in India to successfully carry out a modest sized population-based study; however, we identified some potential problems in conducting a cohort study, such as limited number of facilities to handle biological samples. PMID:21619649

Composition of gallbladder bile in healthy individuals and patients with gallstone disease from north and South India.

PubMed

Jayanthi, V; Sarika, S; Varghese, Joy; Vaithiswaran, V; Sharma, Malay; Reddy, Mettu Srinivas; Srinivasan, Vijaya; Reddy, G M M; Rela, Mohamed; Kalkura, S

2016-09-01

Gallstones (GS) in south India (SI) are predominantly pure pigment or mixed, while in North India (NI), these are either pure cholesterol or mixed. While cholesterol rich gallbladder (GB) bile predicts cholesterol GS, constituent of bile in primary pigment GS is not known. We compared the composition of GB bile from healthy liver donors and patients with GS from north and south India. Gallbladder bile from healthy liver donors from north (10) and south India (8) served as controls. Cases were patients from north (21) and south India (17) who underwent cholecystectomy for GS disease. Gallbladder bile from both cases and controls was analyzed for cholesterol, lecithin (phospholipid), and bile salts. Gallstones were classified as cholesterol, mixed, and pigment based on morphology and biochemical analysis. The median cholesterol concentration in control bile from north was significantly high compared to south (p<0.001) with no difference in lecithin and bile salts (p NS). Except for one sample each from north and south, the cholesterol solubility of controls was within the critical micellar zone. Mixed GS were most frequent in north India (61.9 %) while pigment GS dominated in south (61.9 %). The median cholesterol concentration in bile samples of cholecystectomy patients from north India was significantly high GS (p < 0.00001) with significant lowering of bile salts and lecithin (p < 0.00001). In south India, patients with mixed GS had high cholesterol content in bile compared to controls and patients with pigment GS; bile in latter had significantly higher concentration of bile salt compared to controls and mixed GS. The ternary plot confirmed the composition of GB bile from north and south India. Gallbladder bile in controls and patients with GS from north India had significantly high cholesterol concentration. In south India, patients with mixed GS had cholesterol rich bile while pigment GS had higher concentrations of bile salts.

Lack of active follow-up of cancer patients in Chennai, India: implications for population-based survival estimates

PubMed Central

Rama, Ranganathan; Shanta, Viswanathan

2008-01-01

Abstract Objective To measure the bias in absolute cancer survival estimates in the absence of active follow-up of cancer patients in developing countries. Methods Included in the study were all incident cases of the 10 most common cancers and corresponding subtypes plus all tobacco-related cancers not ranked among the top 10 that were registered in the population-based cancer registry in Chennai, India, during 1990–1999 and followed through 2001. Registered incident cases were first matched with those in the all-cause mortality database from the vital statistics division of the Corporation of Chennai. Unmatched incident cancer cases were then actively followed up to determine their survival status. Absolute survival was estimated by using an actuarial method and applying different assumptions regarding the survival status (alive/dead) of cases under passive and active follow-up. Findings Before active follow-up, matches between cases ranged from 20% to 66%, depending on the site of the primary tumour. Active follow-up of unmatched incident cases revealed that 15% to 43% had died by the end of the follow-up period, while the survival status of 4% to 38% remained unknown. Before active follow-up of cancer patients, 5-year absolute survival was estimated to be between 22% and 47% higher, than when conventional actuarial assumption methods were applied to cases that were lost to follow-up. The smallest survival estimates were obtained when cases lost to follow-up were excluded from the analysis. Conclusion Under the conditions that prevail in India and other developing countries, active follow-up of cancer patients yields the most reliable estimates of cancer survival rates. Passive case follow-up alone or applying standard methods to estimate survival is likely to result in an upward bias. PMID:18670662

Research protocol for an epidemiological study on estimating disease burden of pediatric HIV in Belgaum district, India.

PubMed

Sinha, Anju; Nath, Anita; Sethumadhavan, Rajeev; Isac, Shajy; Washington, Reynold

2016-05-26

Pediatric HIV is poised to become a major public health problem in India with the rising trend of HIV infection in pregnant women (Department of AIDS Control, Ministry of Health and Family Welfare, http://www.naco.gov.in). There is lack of information on the epidemiology of pediatric HIV infection in India. Existing surveillance systems tend to underestimate the Pediatric burden. The overall aim of the present study is to estimate the disease burden of pediatric HIV among children in Belgaum district in the state of Karnataka in Southern India. An innovative multipronged epidemiological approach to comb the district is proposed. The primary objectives of the study would be attained under three strategies. A prospective cohort design for objective (i) to determine the incidence rate of HIV by early case detection in infants and toddlers (0-18 months) born to HIV infected pregnant women; and cross sectional design for objectives (ii) to determine the prevalence of HIV infection in children (0-14 years) of HIV infected parents and (iii) to determine the prevalence of HIV in sick children (0-14 years) presenting with suspected signs and symptoms using age specific criteria for screening. Burden of pediatric HIV will be calculated as a product of cases detected in each strategy multiplied by a net inflation factor for each strategy. Study participants (i) (ii) (iii): HIV infected pregnant women and their live born children (ii) Any HIV-infected man/woman, of age 18-49 years, having a biological child of age 0-14 years (iii) Sick children of age 0-14 years presenting with suspected signs and symptoms and satisfying age-specific criteria for screening. Setting and conduct: Belgaum district which is a Category 'A' district (with more than 1 % antenatal prevalence in the district over the last 3 years before the study). Age-appropriate testing is used to detect HIV infection. There is a need to strengthen existing pediatric HIV estimation methods in India and other developing countries. We hope that the novel methodology emanating from this study would be applicable for estimating the burden of HIV in other settings and it would be adaptable for estimating the burden of other infectious/chronic diseases. Findings from this study will give future direction to the national program for prevention and control of HIV in India and other developing countries.

Acute undifferentiated fever in India: a multicentre study of aetiology and diagnostic accuracy.

PubMed

Mørch, Kristine; Manoharan, Anand; Chandy, Sara; Chacko, Novin; Alvarez-Uria, Gerardo; Patil, Suvarna; Henry, Anil; Nesaraj, Joel; Kuriakose, Cijoy; Singh, Ashita; Kurian, Siby; Gill Haanshuus, Christel; Langeland, Nina; Blomberg, Bjørn; Vasanthan Antony, George; Mathai, Dilip

2017-10-04

The objectives of this study were to determine the proportion of malaria, bacteraemia, scrub typhus, leptospirosis, chikungunya and dengue among hospitalized patients with acute undifferentiated fever in India, and to describe the performance of standard diagnostic methods. During April 2011-November 2012, 1564 patients aged ≥5 years with febrile illness for 2-14 days were consecutively included in an observational study at seven community hospitals in six states in India. Malaria microscopy, blood culture, Dengue rapid NS1 antigen and IgM Combo test, Leptospira IgM ELISA, Scrub typhus IgM ELISA and Chikungunya IgM ELISA were routinely performed at the hospitals. Second line testing, Dengue IgM capture ELISA (MAC-ELISA), Scrub typhus immunofluorescence (IFA), Leptospira Microscopic Agglutination Test (MAT), malaria PCR and malaria immunochromatographic rapid diagnostic test (RDT) Parahit Total™ were performed at the coordinating centre. Convalescence samples were not available. Case definitions were as follows: Leptospirosis: Positive ELISA and positive MAT. Scrub typhus: Positive ELISA and positive IFA. Dengue: Positive RDT and/or positive MAC-ELISA. Chikungunya: Positive ELISA. Bacteraemia: Growth in blood culture excluding those defined as contaminants. Malaria: Positive genus-specific PCR. Malaria was diagnosed in 17% (268/1564) and among these 54% had P. falciparum. Dengue was diagnosed in 16% (244/1564). Bacteraemia was found in 8% (124/1564), and among these Salmonella typhi or S. paratyphi constituted 35%. Scrub typhus was diagnosed in 10%, leptospirosis in 7% and chikungunya in 6%. Fulfilling more than one case definition was common, most frequent in chikungunya where 26% (25/98) also had positive dengue test. Malaria and dengue were the most common causes of fever in this study. A high overlap between case definitions probably reflects high prevalence of prior infections, cross reactivity and subclinical infections, rather than high prevalence of coinfections. Low accuracy of routine diagnostic tests should be taken into consideration when approaching the patient with acute undifferentiated fever in India.

Past, present & future scenario of thalassaemic care & control in India

PubMed Central

Verma, Ishwar C.; Saxena, Renu; Kohli, Sudha

2011-01-01

The first case of thalassaemia, described in a non-Mediterranean person, was from India. Subsequently, cases of thalassaemia were documented in all parts of India. Centres for care of thalassaemics were started in the mid-1970s in Mumbai and Delhi, and then in other cities. The parent's associations, with the help of International Thalassemia Federation, greatly helped in improving the care of thalassaemics. Obtaining blood for transfusion was difficult, but the Indian Red Cross Society and the parent's associations played a crucial role in arranging voluntary donations of blood. Chelation with deferoxamine was used sparingly due to the high cost. The Indian physicians conducted trials with deferiprone, and the drug was first approved and marketed in India. Deferasirox is also now being administered. Studies of physical and pubertal growth documented significant retardation, suggesting that generally patients receive inadequate chelation and transfusions. Bone marrow transplantation is available at a number of centres, and cord blood stem cell storage facilities have been established. Information about mutations in different parts of India is available, and ThalInd, an Indian database has been set up. There is a need to set up preimplantation genetic diagnosis and non-invasive prenatal diagnosis. It is argued that too much emphasis should not be placed on premarital screening. The focus should be on screening pregnant women to yield immediate results in reducing the burden of this disorder. Care of thalassaemia has been included in the 12th 5-year Plan of the Government of India. Many States now provide blood transfusions and chelation free of cost. Although inadequacies in care of thalassaemia remain, but the outlook is bright, and the stage is set for initiating a control programme in the high risk States. PMID:22089615

"To patent or not to patent? the case of Novartis' cancer drug Glivec in India".

PubMed

Gabble, Ravinder; Kohler, Jillian Clare

2014-01-06

Glivec (imatinib mesylate), produced by the pharmaceutical company Novartis, is prescribed in the case of chronic myeloid leukemia, one of the most common blood cancers in eastern countries. After more than a decade of legal battles surrounding its patentability, the Supreme Court of India gave its final decision on April 1st of 2013, rejecting the appeal of the Swiss giant drug manufacturer. In 2006, the Indian Patent Office first refused Glivec's patent under Section 3(d) of the Indian Patent Act arguing that it was only a modified version of an existing drug, Imatinib, and therefore that the drug was not innovative. Novartis replied filing legal challenges against the Indian government but the final verdict in April of 2013 ends the battle. Indeed, the Supreme Court stated that even if the bioavailability of the drug was improved, it did not demonstrate enhanced efficacy and that Glivec was not patentable. The research primarily focused on journal, newspaper and magazine articles relevant to the time frame of the lawsuit (from 1994 to 2013) as well as news searches through Google, Factiva, ProQuest, PubMed, and YouTube where press articles from court verdicts were obtained by using the following keywords: "India", "Novartis", "Glivec", "Patent", "Novartis Case", and "Supreme Court of India". The data sources were interpreted and analyzed according to the authors' own prior knowledge and understanding of the exigencies of the TRIPS Agreement. This case illuminates how India is interpreting international law to fit domestic public health needs. The Novartis case arguably sets an important precedent for the global pharmaceutical industry and ideally will help improve access to lifesaving medicines in the developing world by demanding that patient health needs supersede commercial interests. The Supreme Court of India's decision may affect the interpretation of the article of the TRIPS Agreement, which states members shall be free to determine the appropriate method of implementing the provisions of this Agreement within their own legal system and practice.

A Mixed-Method Study to Determine the Benefits of Periconceptional Folic Acid Supplementation and Effects of Folic Acid Deficiency in Mothers on Birth Outcomes.

PubMed

Murthy, Gudlavalleti Venkata S; Kolli, Sunanda Reddy; Neogi, Sutapa B; Singh, Samiksha; Allagh, Komal Preet; John, Neena; N, Srinivas; Ramani, Sudha; Shamanna, B R; Doyle, Pat; Kinra, Sanjay; Ness, Andy; Pallepogula, Dinesh Raj; Pant, Hira B; Babbar, Smiksha; Reddy, Raghunath; Singh, Rachna

2016-06-23

Evidence from high income countries shows mothers who are supplemented with folic acid in their periconceptional period and early pregnancy have significantly reduced adverse outcomes like birth defects. However, in India there is a paucity of data on association of birth defects and folic acid supplementation. We identified a few important questions to be answered using separate scientific methods and then planned to triangulate the information. In this paper, we describe the protocol of our study that aims to determine the association of folic acid and pregnancy outcomes like neural tube defects (NTDs) and orofacial clefts (OFCs). We decided to fill the gaps in knowledge from India to determine public health consequences of folic acid deficiency and factors influencing dietary and periconceptional consumption of folic acid. The proposed study will be carried out in five stages and will examine the questions related to folic acid deficiency across selected locations in South and North India. The study will be carried out over a period of 4 years through the hierarchical evidence-based approach. At first a systematic review was conducted to pool the current birth prevalence of NTDs and orofacial clefts OFCs in India. To investigate the population prevalence, we plan to use the key informant method to determine prevalence of NTDs and OFCs. To determine the normal serum estimates of folic acid, iron, and vitamin B12 among Indian women (15-35 years), we will conduct a population-based, cross-sectional study. We will further strengthen the evidence of association between OFCs and folic acid by conducting a hospital-based, case-control study across three locations of India. Lastly, using qualitative methods we will understand community and health workers perspective on factors that decide the intake of folic acid supplements. This study will provide evidence on the community prevalence of birth defects and prevalence folic acid and vitamin B12 deficiency in the community. The case-control study will help understand the association of folic acid deficiency with OFCs. The results from this study are intended to strengthen the evidence base in childhood disability for planning and policy initiatives.

The Role of Technology in Mitigating Greenhouse Gas Emissions from Power Sector in Developing Countries: the Case of China, India, and Mexico

EPA Science Inventory

For Frank Princiotta’s book, Global Climate Change—The Technology Challenge China, India, and Mexico are the top emitters of CO2 among developing nations. The electric power sectors in China and India is dominated by coal-fired power plants, whereas in Mexico, fuel oil and natur...

Use of standardised patients to assess antibiotic dispensing for tuberculosis by pharmacies in urban India: a cross-sectional study.

PubMed

Satyanarayana, Srinath; Kwan, Ada; Daniels, Benjamin; Subbaraman, Ramnath; McDowell, Andrew; Bergkvist, Sofi; Das, Ranendra K; Das, Veena; Das, Jishnu; Pai, Madhukar

2016-11-01

India's total antibiotic use is the highest of any country. Patients often receive prescription-only drugs directly from pharmacies. Here we aimed to assess the medical advice and drug dispensing practices of pharmacies for standardised patients with presumed and confirmed tuberculosis in India. In this cross-sectional study in the three Indian cities Delhi, Mumbai, and Patna, we developed two standardised patient cases: first, a patient presenting with 2-3 weeks of pulmonary tuberculosis symptoms (Case 1); and second, a patient with microbiologically confirmed pulmonary tuberculosis (Case 2). Standardised patients were scheduled to present each case once to sampled pharmacies. We defined ideal management for both cases a priori as referral to a health-care provider without dispensing antibiotics or steroids or both. Between April 1, 2014, and Nov 29, 2015, we sampled 622 pharmacies in Delhi, Mumbai, and Patna. Standardised patients completed 1200 (96%) of 1244 interactions. We recorded ideal management (defined as referrals without the use of antibiotics or steroids) in 80 (13%) of 599 Case 1 interactions (95% CI 11-16) and 372 (62%) of 601 Case 2 interactions (95% CI 58-66). Antibiotic use was significantly lower in Case 2 interactions (98 [16%] of 601, 95% CI 13-19) than in Case 1 (221 [37%] of 599, 95% CI 33-41). First-line anti-tuberculosis drugs were not dispensed in any city. The differences in antibiotic or steroid use and number of medicines dispensed between Case 1 and Case 2 were almost entirely attributable to the difference in referral behaviour. Only some urban Indian pharmacies correctly managed patients with presumed tuberculosis, but most correctly managed a case of confirmed tuberculosis. No pharmacy dispensed anti-tuberculosis drugs for either case. Absence of a confirmed diagnosis is a key driver of antibiotic misuse and could inform antimicrobial stewardship interventions. Grand Challenges Canada, Bill & Melinda Gates Foundation, Knowledge for Change Program, and World Bank Development Research Group. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Globalisation of birth markets: a case study of assisted reproductive technologies in India

PubMed Central

2011-01-01

The escalation of Assisted Reproductive Technologies (ARTs) in India into a veritable fertility industry is the result of a multitude of reasons. This paper places the bio-genetic industry within the larger political economy framework of globalisation and privatisation, thus employing a framework that is often omitted from discussions on ARTs, but has direct and significant bearings on the ART industry in India. As markets for human organs, tissues and reproductive body parts experience unprecedented growth, the limits of what can or should be bought and sold continue to be pushed. As such, bodies have emerged as sale-worthy economic capital. Commercial flows of reproductive material create and deploy the division of the body into parts over which ownership is claimed, in the process following 'modern routes of capital' and raising issues of structural inequality. This paper presents a brief picture of India's fertility industry with specific focus on its ground-level operation, nature and growth. It aims to explore the industry dimensions of ARTs, by highlighting the macro picture of health care markets and medical tourism in India, the proliferation of the ART industry, market features such as the social imperative to mother, costs, promotion and marketing, unverified claims, inflated success rates, deals and offers, actors and collaborations in the field, and finally, the absence of standards. This paper presents findings from the research 'Constructing Conceptions: The Mapping of Assisted Reproductive Technologies in India', by Sama, a Delhi-based resource group working on gender, health and rights. This research was conducted from 2008 to 2010 in the three states of Uttar Pradesh, Orissa and Tamil Nadu in India, and is one of the first of its kind, highlighting unethical medical practices and making a case for the regulation of the ART industry. As such, it forms a significant part of Sama's ongoing work on women and technologies, particularly policy-level advocacy. PMID:21838866

Globalisation of birth markets: a case study of assisted reproductive technologies in India.

PubMed

Sarojini, Nadimpally; Marwah, Vrinda; Shenoi, Anjali

2011-08-12

The escalation of Assisted Reproductive Technologies (ARTs) in India into a veritable fertility industry is the result of a multitude of reasons. This paper places the bio-genetic industry within the larger political economy framework of globalisation and privatisation, thus employing a framework that is often omitted from discussions on ARTs, but has direct and significant bearings on the ART industry in India. As markets for human organs, tissues and reproductive body parts experience unprecedented growth, the limits of what can or should be bought and sold continue to be pushed. As such, bodies have emerged as sale-worthy economic capital. Commercial flows of reproductive material create and deploy the division of the body into parts over which ownership is claimed, in the process following 'modern routes of capital' and raising issues of structural inequality.This paper presents a brief picture of India's fertility industry with specific focus on its ground-level operation, nature and growth. It aims to explore the industry dimensions of ARTs, by highlighting the macro picture of health care markets and medical tourism in India, the proliferation of the ART industry, market features such as the social imperative to mother, costs, promotion and marketing, unverified claims, inflated success rates, deals and offers, actors and collaborations in the field, and finally, the absence of standards. This paper presents findings from the research 'Constructing Conceptions: The Mapping of Assisted Reproductive Technologies in India', by Sama, a Delhi-based resource group working on gender, health and rights. This research was conducted from 2008 to 2010 in the three states of Uttar Pradesh, Orissa and Tamil Nadu in India, and is one of the first of its kind, highlighting unethical medical practices and making a case for the regulation of the ART industry. As such, it forms a significant part of Sama's ongoing work on women and technologies, particularly policy-level advocacy.

Healthcare associated infections in Paediatric Intensive Care Unit of a tertiary care hospital in India: Hospital stay & extra costs.

PubMed

Sodhi, Jitender; Satpathy, Sidhartha; Sharma, D K; Lodha, Rakesh; Kapil, Arti; Wadhwa, Nitya; Gupta, Shakti Kumar

2016-04-01

Healthcare associated infections (HAIs) increase the length of stay in the hospital and consequently costs as reported from studies done in developed countries. The current study was undertaken to evaluate the impact of HAIs on length of stay and costs of health care in children admitted to Paediatric Intensive Care Unit (PICU) of a tertiary care hospital in north India. This prospective study was done in the seven bedded PICU of a large multi-specialty tertiary care hospital in New Delhi, India. A total of 20 children with HAI (cases) and 35 children without HAI (controls), admitted to the PICU during the study period (January 2012 to June 2012), were matched for gender, age, and average severity of illness score. Each patient's length of stay was obtained prospectively. Costs of healthcare were estimated according to traditional and time driven activity based costing methods approach. The median extra length of PICU stay for children with HAI (cases), compared with children with no HAI (controls), was seven days (IQR 3-16). The mean total costs of patients with and without HAI were ' 2,04,787 (US$ 3,413) and ' 56,587 (US$ 943), respectively and the mean difference in the total cost between cases and controls was ' 1,48,200 (95% CI 55,716 to 2,40,685, p<0.01). This study highlights the effect of HAI on costs for PICU patients, especially costs due to prolongation of hospital stay, and suggests the need to develop effective strategies for prevention of HAI to reduce costs of health care.

Clinical spectrum of hypopituitarism in India: A single center experience

PubMed Central

Gundgurthi, Abhay; Garg, M. K.; Bhardwaj, Reena; Brar, Karninder S.; Kharb, Sandeep; Pandit, Aditi

2012-01-01

Objectives: There is paucity of information regarding clinical profile of hypopituitarism from India. We report the clinical profile of hypopituitarism from a tertiary center in North India. Materials and Methods: This study was carried out in patients attending our endocrine center between January 2010 and December 2011. All new patients were studied prospectively and those registered before January 2010 retrospectively. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing for pituitary functions was carried out as necessary. Hormonal deficiencies were defined as per prevailing recommendations. Results: This study included 113 subjects. The mean age was 38.6 ± 17.8 years (range, 4 – 76 years). There were 78 (69%) males and 35 females (31%). There were 22 subjects aged ≤18 years (childhood and adolescence) and 91 adults (>18 years). Visual disturbances were the most common presenting complaint (33%), though headache was the most common symptom (81%). Fifteen percent presented with pituitary apoplexy. Tumors comprised of 84% of cases. Hypogonadism (97%) was the most common abnormality seen followed by hypothyroidism (83.2%), hypoadrenalism (79.6%), growth hormone deficiency (88.1% of the 42 patients tested), and diabetes insipidus (13.3%). Panhypopituitarism was seen in 104 (92%) patients. There were no cases of hypopituitarism secondary to traumatic brain injury, subarachnoid hemorrhage, central nervous system infections, or cranial irradiation to extrasellar tumors. Conclusion: The most common cause of hypopituitarism at tertiary care center is pituitary tumors and the commonest presenting complaint is visual symptoms. Panhypopituitarism is present in 92% cases. PMID:23087868

Neonaticide in India and the stigma of female gender: report of two cases.

PubMed

Mishra, Kirtisudha; Ramachandran, Smita; Kumar, Ajay; Tiwari, Soumya; Chopra, Nidhi; Datta, Vikram; Saili, Arvind

2014-08-01

Neonaticide is known to occur across the globe in both developed and developing countries, but has rarely been reported from India. Two similar cases of female neonaticide are presented which were committed by their mothers while in the maternity ward. The social issues and maternal provocation highlighted in this report are different from those reported in world reviews of neonaticide.

Malaria-related knowledge and prevention practices in four neighbourhoods in and around Mumbai, India: a cross-sectional study.

PubMed

Dhawan, Gaurav; Joseph, Nidhin; Pekow, Penelope S; Rogers, Christine A; Poudel, Krishna C; Bulzacchelli, Maria T

2014-08-07

India accounts for the highest number of malaria cases outside of Africa. Eighty per cent of India's population lives in malaria-risk areas, with cases increasing in urban areas. Mumbai, India, one of the most populous cities in the world, has experienced such an increase. To be successful, many malaria control efforts require community participation, which in turn depends on individuals' knowledge and awareness of the disease. This study assessed the knowledge and prevention practices regarding malaria in residents of four different areas of Mumbai, India, around the time of a malaria outbreak and the start of a widespread awareness campaign. A cross-sectional comparative study assessed malaria-related knowledge and prevention practices in four geographically and socio-demographically distinct areas of Mumbai, India. A structured interviewer-administered questionnaire was administered to a stratified random sample of 119 households between 16 December 2010 and 30 January 2011. Participant socio-demographic characteristics, malaria knowledge, malaria prevention practices, and household environmental factors were examined overall and compared across the four areas of Mumbai. Overall, respondents had excellent knowledge of the mosquito as the means of transmission of malaria, mosquito biting times and breeding sites, and fever as a symptom of malaria. However, many respondents also held misconceptions about malaria transmission and symptoms. Respondents generally knew that bed nets are an effective prevention strategy, but only 30% used them, and only 4% used insecticide-treated bed nets. Knowledge and prevention practices varied across the four areas of Mumbai. Although most residents know that bed nets are effective in preventing malaria, usage of bed nets is very low, and almost no residents use insecticide-treated bed nets. As the four areas of Mumbai differed in knowledge, prevention practices, and primary sources of information, malaria control campaigns should be tailored according to the knowledge gaps, practices, environments, resources, and preferences in different areas of the city, using the interpersonal and media channels most likely to reach the target audiences. Malaria control efforts involving bed nets should emphasize use of insecticide-treated bed nets.

Standardizing evaluation process: Necessary for achieving SDGs - A case study of India.

PubMed

Srivastava, Alok

2018-05-09

A set of 17 Sustainable Development Goals (SDGs) adopted by the United Nations General Assembly in September 2015 are to be implemented and achieved in every country from the year 2016 to 2030. In Indian context, all these goals are very relevant and critical, as India missed the target on many components of the Millennium Development Goals (MDGs). The author strongly feels that one of the key reasons was lack of an in-built robust system for measuring the progress and achievements of MDGs. Monitoring and Evaluation of programmes and schemes, aiming at different SDGs, in a robust and regular manner is therefore need of the hour. A National evaluation policy (NEP) would set the tone in the right direction from the very beginning for achieving SDGs. The paper taking India as a case study discusses different critical factors pertinent for having a well laid down national level policy towards standardizing evaluation. Using real examples under different components of an evaluation policy, the paper discusses and questions the credibility and acceptance of the present evaluation system in place. The paper identifies five core mantras or pre-requisites of a national evaluation guideline. The paper emphasizes the importance of an evaluation policy in India and other countries as well, to provide authentic data gathered through a well-designed evaluation process and take corrective measures well on time to achieve SDGs. Copyright © 2018 Elsevier Ltd. All rights reserved.

Multiplex PCR technique could be an alternative approach for early detection of leprosy among close contacts--a pilot study from India.

PubMed

Banerjee, Surajita; Sarkar, Kamalesh; Gupta, Soma; Mahapatra, Prasanta Sinha; Gupta, Siddhartha; Guha, Samudra; Bandhopadhayay, Debasis; Ghosal, Chaitry; Paine, Suman Kalyan; Dutta, Rathindra Nath; Biswas, Nibir; Bhattacharya, Basudev

2010-08-24

Implementation of Multi drug Therapy (MDT) regimen has resulted in the decline of the total number of leprosy cases in the world. Though the prevalence rate has been declining, the incidence rate remains more or less constant and high in South East Asian countries particularly in India, Nepal, Bangladesh, Pakistan and Srilanka. Leprosy, particularly that of multibacillary type spreads silently before it is clinically detected. An early detection and treatment would help to prevent transmission in the community. Multiplex PCR (M-PCR) technique appears to be promising towards early detection among contacts of leprosy cases. A total of 234 paucibacillary (PB) and 205 multibacillary (MB) leprosy cases were studied in a community of an endemic area of Bankura district of West Bengal (Eastern India). They were assessed by smear examination for acid-fast bacilli (AFB) and M-PCR technique. These patients were treated with Multidrug Therapy (MDT) as prescribed by WHO following detection. A total of 110 MB and 72 PB contacts were studied by performing M-PCR in their nasal swab samples. 83.4% of MB patients were observed to be positive by smear examination for AFB and 89.2% by M-PCR. While 22.2% of PB patients were found to be positive by smear examination for AFB, 80.3% of these patients were positive by M-PCR. Among leprosy contacts (using M-PCR), 10.9% were found to be positive among MB contacts and 1.3% among PB contacts. Interestingly, two contacts of M-PCR positive MB cases developed leprosy during the period of two years follow up. The M-PCR technique appears to be an efficient tool for early detection of leprosy cases in community based contact tracing amongst close associates of PB and MB cases. Early contact tracing using a molecular biology tool can be of great help in curbing the incidence of leprosy further.

Contaminated drinking water and rural health perspectives in Rajasthan, India: an overview of recent case studies.

PubMed

Suthar, Surindra

2011-02-01

Access to safe drinking water is an important issue of health and development at national, regional, and local levels. The concept of safe drinking water assumes greater significance in countries like India where the majority of the population lives in villages with bare infrastructures and poor sanitation facilities. This review presents an overview of drinking water quality in rural habitations of northern Rajasthan, India. Although fluoride is an endemic problem to the groundwater of this region, recently, other anthropogenic chemicals has also been reported in the local groundwater. Recent case studies indicate that about 95% of sites of this region contain a higher fluoride level in groundwater than the maximum permissible limit as decided by the Bureau of Indian Standards. Nitrate (as NO3-) contamination has appeared as another anthropogenic threat to some intensively cultivable rural habitations of this region. Biological contamination has appeared as another issue of unsafe drinking water resources in rural areas of the state. Recent studies have claimed a wide variety of pathogenic bacteria including members of the family Enterobacteriaceae in local drinking water resources. Overall, the quality of drinking water in this area is not up to the safe level, and much work is still required to establish a safe drinking water supply program in this area.

A Study of Workplace Violence Experienced by Doctors and Associated Risk Factors in a Tertiary Care Hospital of South Delhi, India

PubMed Central

Kumar, Mukesh; Das, Timiresh; Pardeshi, Geeta; Kishore, Jugal; Padmanandan, Arun

2016-01-01

Introduction The increasing incidences of violence against doctors in their workplaces are an important reason for stress among these healthcare workers. Many incidences of workplace violence against doctors have been reported in the past and are also being continuously reported from different parts of the country as well as the world. Aim To determine the prevalence of workplace violence among doctors and to study the associated risk factors in a tertiary care hospital of Delhi, India. Material and Methods A cross-sectional study was conducted using a self-administered semi-structured questionnaire. The contents were: data related to the workplace, incidences at work, violence prevention policy of the institution, reporting of incidences and follow-up, education and training for violence management. A total of 151 doctors participated in the study. Results Total participants in the study were 151. The mean age of study participants was 26.73±4.24 years. Almost half (47.02%; 44.56% of males and 50.84% of females) of the doctors reported having an experience of violence during work hours in past 12 months. Among the cases, 39.4% were reported from Department of Obstetrics and Gynaecology while Surgery, Medicine and other departments reported 29.6%, 26.8% and 4.2% respectively. Patients or their relatives were perpetrators in most of the cases. Maximum (87.3%) of the reported cases were of verbal violence while 8.6% of the cases were of physical violence. Younger doctors with less work experience were more prone to physical violence. Regarding the time of violence, 35.1% of such cases occurred during afternoon while 30.1% of them took place at night. Conclusion A large number of doctors had experienced violence in past 12 months in a tertiary care hospital of South Delhi, India. Verbal violence came out to be most common form of violence experienced by the doctors. Afternoon or night hours were the timings when majority of such cases were reported. PMID:28050406

A case-control study of maternal knowledge of malnutrition and health-care-seeking attitudes in rural South India.

PubMed

Saito, K; Korzenik, J R; Jekel, J F; Bhattacharji, S

1997-01-01

In India, approximately 20 percent of children under the age of four suffer from severe malnutrition, while half of all the children suffer from undernutrition. The contributions of knowledge and attitudes of nutrition-conscious behaviors of the mothers to childhood malnutrition has been unclear. The purpose of this study was to explore maternal knowledge of the causes of malnutrition, health-care-seeking attitudes and socioeconomic risk factors in relation to children's nutritional status in rural south India. A case-controlled study was conducted in a rural area in Tamil Nadu, India. Thirty-four cases and 34 controls were selected from the population of approximately 97,000 by using the local hospital's list of young children. A case was defined as a mother of a severely malnourished child under four years of age. Severe malnutrition was defined as having less than 60 percent of expected median weight-for-age. A control had a well-nourished child and was matched by the location and the age of the child. Interviews obtained: (1) socioeconomic information on the family, (2) knowledge of the cause of malnutrition and (3) health-care-seeking attitudes for common childhood illnesses, including malnutrition. Poor nutritional status was associated with socioeconomic variables such as sex of the child and father's occupation. Female gender (OR = 3.44, p = .02) and father's occupation as a laborer (OR = 2.98, p = .05) were significant risk factors for severe malnutrition. The two groups showed a significant difference in nutrition-related knowledge of mild mixed malnutrition (OR = 2.62, p = .05). No significant difference was apparent in health-care-seeking attitudes. Based on their traditional beliefs, the mothers did not believe that medical care was an appropriate intervention for childhood illnesses such as malnutrition or measles. The results suggested that the gender of the child and socioeconomic factors were stronger risk factors for malnutrition than health-care availability and health-care-seeking attitudes. The father's occupation was a more accurate indicator for malnutrition than household income. These results suggest a need for intensive nutritional programs targeted toward poor female children and their mothers.

Solar power potential of North-east India - A case study for Silchar

NASA Astrophysics Data System (ADS)

Maisanam, Anil; Biswas, Agnimitra; Sharma, Kaushal Kumar

2018-04-01

High energy demand has necessitated search for all possible sources of energy. Conventional energy source is having negative impact on our environment, therefore our attention is focused on renewable energy sources, such as solar, wind, hydro, which are considered to be clean and sustainable energy sources. India has set an ambitious target of producing 175 GW of energy using solar energy. Therefore, it is necessary to estimate the solar potential to observe the feasibility of such project. North-east India is an underdeveloped region of India and due to its geographical location and difficult terrain, many regions are still not electrified. Such regions can be electrified by installing renewable energy based power plants, which can also generate number of jobs hence improving the quality of life and economic condition of the region. The objective of this paper is to estimate the solar power potential of Silchar (Assam, India) and perform a feasibility study for installation of solar-based power plant in the region. In this paper, solar radiation on tilted surface is estimated by using an anisotropic sky model. This radiation data has been used to estimate the PV power output. Finally, feasibility of the PV plant has been verified by mapping with a practical load demand.

p16 gene silencing along with p53 single-nucleotide polymorphism and risk of esophageal cancer in Northeast India.

PubMed

Das, Mandakini; Sharma, Santanu Kumar; Sekhon, Gaganpreet Singh; Mahanta, Jagadish; Phukan, Rup Kumar; Jalan, Bimal Kumar

2017-05-01

The high incidence of esophageal cancer in Northeast India and the unique ethnic background and dietary habits provide a great opportunity to study the molecular genetics behind esophageal squamous cell carcinoma in this part of the region. We hypothesized that in addition to currently known environmental risk factors for esophageal cancer, genetic and epigenetic factors are also involved in esophageal carcinogenesis in Northeast India. Therefore, in this study, we explored the possible association between the two important G1 cell cycle regulatory genes p16 and p53 and environmental risk factors and risk of esophageal carcinogenesis. A total of 100 newly diagnosed esophageal cancer cases along with equal number of age-, sex-, and ethnicity-matched controls were included in this study. Methylation-specific polymerase chain reaction was used to determine the p16 promoter methylation status. Single-nucleotide polymorphism at codon 72 of p53 gene was assessed by the polymerase chain reaction-restriction fragment length polymorphism method. Aberrant methylation of p16 gene was seen in 81% of esophageal cancer cases. Hypermethylation of p16 gene was not found in healthy controls. p53 Pro/Pro genotype was found to be a risk genotype in Northeast India compared with Arg/Pro and Arg/Arg. p53 variant/polymorphism was significantly associated with esophageal cancer risk in the study population under all three genetic models, namely, dominant model (Arg/Pro + Pro/Pro vs Arg/Arg odds ratio = 2.25, confidence interval = 1.19-4.26; p = 0.012), recessive model (Arg/Arg + Arg/Pro vs Pro/Pro odds ratio = 2.35, confidence interval = 1.24-4.44; p = 0.008), and homozygous model (Pro/Pro vs Arg/Arg odds ratio = 3.33, confidence interval = 1.54-7.20; p = 0.002). However, p53 variant/polymorphism was not statistically associated with esophageal cancer risk under the heterozygous model (Pro/Pro vs Arg/Pro). In the case-only analysis based on p16 methylation, the p53 variant/polymorphism (Pro/Pro or Arg/Pro) showed significant association for esophageal cancer risk (odds ratio = 3.33, confidence interval = 1.54-7.20; p = 0.002). Gene-gene and gene-environment interaction using the case-only approach revealed a strong association between p16 methylation, p53 single-nucleotide polymorphism, and environmental factors and esophageal cancer risk. Cases with p16 methylation and p53 variant/polymorphism (Pro/Pro or Arg/Pro) along with both betel quid and tobacco chewing habit (odds ratio = 8.29, confidence interval = 1.14-60.23; p = 0.037) conferred eightfold increased risk toward esophageal cancer development. This study reveals a synergistic interaction between epigenetic, genetic, and environmental factors and risk of esophageal cancer in this high-incidence region of Northeast India. The inactivation of either p16 or p53 in a majority of esophageal cancer cases in this study suggests the possible crosstalk between the important cell cycle genes.

Rapid molecular diagnostics for multi-drug resistant tuberculosis in India.

PubMed

Ramachandran, Rajeswari; Muniyandi, M

2018-03-01

Rapid molecular diagnostic methods help in the detection of TB and Rifampicin resistance. These methods detect TB early, are accurate and play a crucial role in reducing the burden of drug resistant tuberculosis. Areas covered: This review analyses rapid molecular diagnostic tools used in the diagnosis of MDR-TB in India, such as the Line Probe Assay and GeneXpert. We have discussed the burden of MDR-TB and the impact of recent diagnostic tools on case detection and treatment outcomes. This review also discusses the costs involved in establishing these new techniques in India. Expert commentary: Molecular methods have considerable advantages for the programmatic management of drug resistant TB. These include speed, standardization of testing, potentially high throughput and reduced laboratory biosafety requirements. There is a desperate need for India to adopt modern, rapid, molecular tools with point-of-care tests being currently evaluated. New molecular diagnostic tests appear to be cost effective and also help in detecting missing cases. There is enough evidence to support the scaling up of these new tools in India.

Intensified Tuberculosis Case Finding among Malnourished Children in Nutritional Rehabilitation Centres of Karnataka, India: Missed Opportunities

PubMed Central

Bhat, Prashant G.; Kumar, Ajay M. V.; Naik, Balaji; Satyanarayana, Srinath; KG, Deepak; Nair, Sreenivas A.; MD, Suryakanth; Heldal, Einar; Enarson, Donald A.; Reid, Anthony J.

2013-01-01

Background Severe acute malnutrition (SAM) is the most serious form of malnutrition affecting children under-five and is associated with many infectious diseases including Tuberculosis (TB). In India, nutritional rehabilitation centres (NRCs) have been recently established for the management of SAM including TB. The National TB Programme (NTP) in India has introduced a revised algorithm for diagnosing paediatric TB. We aimed to examine whether NRCs adhered to these guidelines in diagnosing TB among SAM children. Methods A cross-sectional study involving review of records of all SAM children identified by health workers during 2012 in six tehsils (sub-districts) with NRCs (population: 1.8 million) of Karnataka, India. Results Of 1927 identified SAM children, 1632 (85%) reached NRCs. Of them, 1173 (72%) were evaluated for TB and 19(2%) were diagnosed as TB. Of 1173, diagnostic algorithm was followed in 460 (37%). Among remaining 763 not evaluated as per algorithm, tuberculin skin test alone was conducted in 307 (41%), chest radiography alone in 99 (13%) and no investigations in 337 (45%). The yield of TB was higher among children evaluated as per algorithm (4%) as compared to those who were not (0.3%) (OR: 15.3 [95%CI: 3.5-66.3]). Several operational challenges including non-availability of a full-time paediatrician, non-functioning X-ray machine due to frequent power cuts, use of tuberculin with suboptimal strength and difficulties in adhering to a complex diagnostic algorithm were observed. Conclusion This study showed that TB screening in NRCs was sub-optimal in Karnataka. Some children did not reach the NRC, while many of those who did were either not or sub-optimally evaluated for TB. This study pointed to a number of operational issues that need to be addressed if this collaborative strategy is to identify more TB cases amongst malnourished children in India. PMID:24358350

Snowball Vs. House-to-House Technique for Measuring Annual Incidence of Kala-azar in the Higher Endemic Blocks of Bihar, India: A Comparison

PubMed Central

Siddiqui, Niyamat A.; Rabidas, Vidya N.; Sinha, Sanjay K.; Verma, Rakesh B.; Pandey, Krishna; Singh, Vijay P.; Ranjan, Alok; Topno, Roshan K.; Lal, Chandra S.; Kumar, Vijay; Sahoo, Ganesh C.; Sridhar, Srikantaih; Pandey, Arvind; Das, Pradeep

2016-01-01

Background Visceral Leishmaniasis, commonly known as kala-azar, is widely prevalent in Bihar. The National Kala-azar Control Program has applied house-to-house survey approach several times for estimating Kala-azar incidence in the past. However, this approach includes huge logistics and operational cost, as occurrence of kala-azar is clustered in nature. The present study aims to compare efficiency, cost and feasibility of snowball sampling approach to house-to-house survey approach in capturing kala-azar cases in two endemic districts of Bihar, India. Methodology/Principal findings A community based cross-sectional study was conducted in two highly endemic Primary Health Centre (PHC) areas, each from two endemic districts of Bihar, India. Snowball technique (used to locate potential subjects with help of key informants where subjects are hard to locate) and house-to-house survey technique were applied to detect all the new cases of Kala-azar during a defined reference period of one year i.e. June, 2010 to May, 2011. The study covered a total of 105,035 households with 537,153 populations. Out of total 561 cases and 17 deaths probably due to kala-azar, identified by the study, snowball sampling approach captured only 221 cases and 13 deaths, whereas 489 cases and 17 deaths were detected by house-to-house survey approach. Higher value of McNemar’s χ² statistics (64; p<0.0001) for house-to-house survey approach than snowball sampling and relative difference (>1) indicates that most of the kala-azar cases missed by snowball sampling were captured by house-to-house approach with 13% of omission. Conclusion/Significance Snowball sampling was not found sensitive enough as it captured only about 50% of VL cases. However, it captured about 77% of the deaths probably due to kala-azar and was found more cost-effective than house-to-house approach. Standardization of snowball approach with improved procedure, training and logistics may enhance the sensitivity of snowball sampling and its application in national Kala-azar elimination programme as cost-effective approach for estimation of kala-azar burden. PMID:27681709

Snowball Vs. House-to-House Technique for Measuring Annual Incidence of Kala-azar in the Higher Endemic Blocks of Bihar, India: A Comparison.

PubMed

Siddiqui, Niyamat A; Rabidas, Vidya N; Sinha, Sanjay K; Verma, Rakesh B; Pandey, Krishna; Singh, Vijay P; Ranjan, Alok; Topno, Roshan K; Lal, Chandra S; Kumar, Vijay; Sahoo, Ganesh C; Sridhar, Srikantaih; Pandey, Arvind; Das, Pradeep

2016-09-01

Visceral Leishmaniasis, commonly known as kala-azar, is widely prevalent in Bihar. The National Kala-azar Control Program has applied house-to-house survey approach several times for estimating Kala-azar incidence in the past. However, this approach includes huge logistics and operational cost, as occurrence of kala-azar is clustered in nature. The present study aims to compare efficiency, cost and feasibility of snowball sampling approach to house-to-house survey approach in capturing kala-azar cases in two endemic districts of Bihar, India. A community based cross-sectional study was conducted in two highly endemic Primary Health Centre (PHC) areas, each from two endemic districts of Bihar, India. Snowball technique (used to locate potential subjects with help of key informants where subjects are hard to locate) and house-to-house survey technique were applied to detect all the new cases of Kala-azar during a defined reference period of one year i.e. June, 2010 to May, 2011. The study covered a total of 105,035 households with 537,153 populations. Out of total 561 cases and 17 deaths probably due to kala-azar, identified by the study, snowball sampling approach captured only 221 cases and 13 deaths, whereas 489 cases and 17 deaths were detected by house-to-house survey approach. Higher value of McNemar's χ² statistics (64; p<0.0001) for house-to-house survey approach than snowball sampling and relative difference (>1) indicates that most of the kala-azar cases missed by snowball sampling were captured by house-to-house approach with 13% of omission. Snowball sampling was not found sensitive enough as it captured only about 50% of VL cases. However, it captured about 77% of the deaths probably due to kala-azar and was found more cost-effective than house-to-house approach. Standardization of snowball approach with improved procedure, training and logistics may enhance the sensitivity of snowball sampling and its application in national Kala-azar elimination programme as cost-effective approach for estimation of kala-azar burden.

Postelimination Status of Childhood Leprosy: Report from a Tertiary-Care Hospital in South India

PubMed Central

Chaitra, P.; Bhat, Ramesh Marne

2013-01-01

Introduction. Leprosy, a statistically “eliminated” disease from the globe, continues to linger around in its endemic countries including India. Objective. This study describes the epidemiological and clinicopathological pattern of the disease seen in children over a period of 8 years following its elimination in India. Materials and Methods. Medical records of all leprosy cases up to 14 years of age registered between April 2005 and March 2013 were retrospectively analyzed. Data were retrieved using a predesigned proforma and entered into the database system for analysis. Results. Child proportion of newly registered leprosy cases did not show a significant decline in the years following its elimination. The disease seemed to manifest frequently in older children with an insignificant gender predilection. More than half of child cases had a history of household contact. Paucibacillary leprosy dominated in them with a solitary skin lesion as the most frequent presentation. Although nerve thickening was seen in nearly half of these children, neuritis and lepra reactions were less common. Deformity at the time of diagnosis was noted in 13.89% of cases. Although smear positivity was not a common feature in children affected with leprosy, a good clinicohistopathological correlation was observed in those who underwent biopsy. Conclusion. Our study and reports from different parts of the country depict the unturned curves in the epidemiology of childhood leprosy which mirrors active transmission in the community, lacunae in diagnosis, and the need to strengthen contact screening activities in the pediatric population to sustain elimination. PMID:24089672

Sexual behavior and condom use among seasonal Dalit migrant laborers to India from Far West, Nepal: a qualitative study.

PubMed

Bam, Kiran; Thapa, Rajshree; Newman, Marielle Sophia; Bhatt, Lokesh Prasad; Bhatta, Shree Krishna

2013-01-01

Around 41% of Human Immunodeficiency Virus (HIV) cases in Nepal occur in seasonal migrant laborers. Dalit migrant laborers represent the largest proportion of reported HIV cases in the Far Western Region (Sudur Pashchimanchal, or Far West), Nepal. The study's objectives were to assess sexual behavior, condom use status and HIV risk perception among Dalit migrant laborers to India from Far West Region, Nepal. The study was conducted among Dalit male migrant laborers aged 15 years and above who had migrated for at least six months of the last two years to India. For the sampling the village development committees (VDCs) from Achham, Doti and Kanchanpur districts of Nepal were purposively selected. The data were collected in March and April 2011 via ten in-depth interviews and four focus group discussions and analyzed using content analysis. Poor socio-economic status, caste-related discrimination, and lack of employment opportunities push large groups of young Dalits to migrate to India for employment, where they engage in sex with female sex workers (FSWs). The participants described unmarried status, peer influence, alcohol use, low-priced sex with FSWs and unwillingness to use condoms as common factors of their migration experience. Lack of awareness on HIV/AIDS was common among study participants. Awareness of HIV/AIDS and faithful, monogamous partnerships are reported as factors influencing safer sexual behavior. Dalits are an especially vulnerable population among migrant laborers and may be over-represented in new HIV infections in Nepal. Comprehensive surveying and health promotion programs targeted to this population are urgently needed and potent methods of stopping HIV spread.

Maternal hormonal interventions as a risk factor for Autism Spectrum Disorder: an epidemiological assessment from India.

PubMed

Mamidala, Madhu Poornima; Polinedi, Anupama; Kumar, P T V Praveen; Rajesh, N; Vallamkonda, Omsai Ramesh; Udani, Vrajesh; Singhal, Nidhi; Rajesh, Vidya

2013-12-01

Globalization and women empowerment have led to stressful life among Indian women. This stress impairs women's hormonal makeup and menstrual cycle, leading to infertility. National Family Health Survey-3 (NFHS-3) reports a decline in fertility status in India, indicating a rise in various infertility treatments involving hormonal interventions. No studies are available from India on the risk association link between maternal hormonal treatments and ASD. Hence, this study explores the association of maternal hormonal interventions with risk for ASD. Parents of 942 children (471 ASD and 471 controls) across 9 cities in India participated in the questionnaire-based study. The questionnaire was pilot tested and validated for its content and reliability as a psychometric instrument. Data collection was done at 70 centres through direct interaction with parents and with the help of trained staff. Statistical analysis of data was carried out using SAS 9.1.3. Out of the 471 ASD cases analysed, 58 mothers had undergone hormonal interventions (12.3 percent) while there were only 22 mothers among controls who underwent hormonal interventions (4.6 percent). According to logistic regression analysis maternal hormonal intervention (OR=2.24) was a significant risk factor for ASD.

An urgent need for building technical capacity for rapid diagnosis of multidrug-resistant tuberculosis (MDR-TB) among new cases: A case report from Maharashtra, India.

PubMed

Atre, Sachin

2015-01-01

Multidrug-resistant tuberculosis (MDR-TB), the prevalence of which has increased across the globe in recent years, is a serious threat to public health. Timely diagnosis of MDR-TB, especially among new TB cases, is essential to facilitate appropriate treatment, which can prevent further emergence of drug resistance and its spread in the population. The present case report from India aims to address some operational challenges in diagnosing MDR-TB among new cases and potential measures to overcome them. It argues that even after seven years of implementing the DOTS-Plus program for controlling MDR-TB, India still lacks the technical capacity for rapid MDR-TB diagnosis. The case report underscores an urgent need to explore the use of WHO-endorsed techniques such as Xpert MTB/Rif and commercial assays such as Genotype MTBDR for rapid diagnosis of MDR-TB among new cases. Suitable applications may be found for other TB high-burden countries where MDR-TB is a major concern. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Demographic and socio-economic determinants of post-neonatal deaths in a special project area of rural northern India.

PubMed

Kabir, Zubair

2003-07-01

The demographic and socio-economic determinants of post-neonatal deaths (n = 475) in a special project area of rural northern India (Ballabgarh) were ascertained from 1991 to 1999 using the electronic database system of the project area for data extraction, and were compared with the eligible living children of the same age using a matched population-based case-control study design. Similar determinants were also ascertained in neonatal deaths (n = 212) using the same study design. After controlling for the potential confounders using conditional logistic regression analyses, lower caste (a proxy measure for low socio-economic conditions in rural India) was found to be significantly associated with higher post-neonatal deaths (OR = 2.21). Higher maternal age (>30 years) and fathers' lower educational levels were significantly associated with higher neonatal deaths, in addition to higher post-neonatal deaths in the same area.

Final chapter, From India to the Planet Mars: A Study of a Case of Somnambulism with Glossolalia, by Théodore Flournoy (1900).

PubMed

de Oliveira Maraldi, Everton; Alvarado, Carlos S

2018-03-01

Among the many attempts to explain mediumship psychologically at the turn of the century were the efforts of Swiss psychologist Théodore Flournoy (1854-1920). In his well-known book Des Indes à la Planète Mars (1900), translated as From India to the Planet Mars (1900), Flournoy analysed the mediumistic productions of medium Hélène Smith (1861-1929), consisting of accounts of previous lives in France and in India, and material about planet Mars. Flournoy explained the phenomena as a function of cryptomnesia, suggestive influences, and subconscious creativity, analyses that influenced both psychology and psychical research. The purpose of this Classic Text is to reprint the conclusion of Flournoy's study, whose ideas were developed in the context of psychological attention to mediumship and secondary personalities.

Disease burden due to biomass cooking-fuel-related household air pollution among women in India.

PubMed

Sehgal, Meena; Rizwan, Suliankatchi Abdulkader; Krishnan, Anand

2014-01-01

Household air pollution (HAP) due to biomass cooking fuel use is an important risk factor for a range of diseases, especially among adult women who are primary cooks, in India. About 80% of rural households in India use biomass fuel for cooking. The aim of this study is to estimate the attributable cases (AC) for four major diseases/conditions associated with biomass cooking fuel use among adult Indian women. We used the population attributable fraction (PAF) method to calculate the AC of chronic bronchitis, tuberculosis (TB), cataract, and stillbirths due to exposure to biomass cooking fuel. A number of data sources were accessed to obtain population totals and disease prevalence rates. A meta-analysis was conducted to obtain adjusted pooled odds ratios (ORs) for strength of association. Using this, PAF and AC were calculated using a standard formula. Results were presented as number of AC and 95% confidence intervals (CI). The fixed effects pooled OR obtained from the meta-analysis were 2.37 (95% CI: 1.59, 3.54) for chronic bronchitis, 2.33 (1.65, 3.28) for TB, 2.16 (1.42, 3.26) for cataract, and 1.26 (1.12, 1.43) for stillbirths. PAF varied across conditions being maximum (53%) for chronic bronchitis in rural areas and least (1%) for cataract in older age and urban areas. About 2.4 (95% CI: 1.4, 3.1) of 5.6 m cases of chronic bronchitis, 0.3 (0.2, 0.4) of 0.76 m cases of TB, 5.0 (2.8, 6.7) of 51.4 m cases of cataract among adult Indian women and 0.02 (0.01, 0.03) of 0.15 m stillbirths across India are attributable to HAP due to biomass cooking fuel. These estimates should be cautiously interpreted in the light of limitations discussed which relate to exposure assessment, exposure characterization, and age-specific prevalence of disease. HAP due to biomass fuel has diverse and major impacts on women's health in India. Although challenging, incorporating the agenda of universal clean fuel access or cleaner technology within the broader framework of rural development will go a long way in reducing disease burden.

Molecular Characterization of Echinococcus granulosus Cysts in North Indian Patients: Identification of G1, G3, G5 and G6 Genotypes

PubMed Central

Sharma, Monika; Sehgal, Rakesh; Fomda, Bashir Ahmad; Malhotra, Anil; Malla, Nancy

2013-01-01

Background Cystic echinococcosis (CE) caused by the Echinococcus granulosus, is a major public health problem worldwide, including India. The different genotypes of E. granulosus responsible for human hydatidosis have been reported from endemic areas throughout the world. However, the genetic characterization of E. granulosus infecting the human population in India is lacking. The aim of study was to ascertain the genotype(s) of the parasite responsible for human hydatidosis in North India. Methodology/Principal Findings To study the transmission patterns of E. granulosus, genotypic analysis was performed on hydatid cysts obtained from 32 cystic echinococcosis (CE) patients residing in 7 different states of North India. Mitochondrial cytochrome c oxidase subunit1 (cox1) sequencing was done for molecular identification of the isolates. Most of the CE patients (30/32) were found to be infected with hydatid cyst of either G3 (53.1%) or G1 (40.62%) genotype and one each of G5 (cattle strain) and G6 (camel strain) genotype. Conclusions/Significance These findings demonstrate the zoonotic potential of G1 (sheep strain) and G3 (buffalo strain) genotypes of E. granulosus as these emerged as predominant genotypes infecting the humans in India. In addition to this, the present study reports the first human CE case infected with G5 genotype (cattle strain) in an Asian country and presence of G6 genotype (camel strain) in India. The results may have important implications in the planning of control strategies for human hydatidosis. PMID:23785531

A case for internal migration policy in India.

PubMed

Ram, S

1993-01-01

Migration helps to minimize regional, socioeconomic, and cultural disparities, and is considered to be an integral component of the development process. Migration helps to diffuse development, technology, and innovations from more developed areas or cities to rural or less developed areas. Little attention, however, has been paid to migration policy in India. Most studies on migration in India either describe the patterns of migration or analyze reasons for the moves. This paper discusses why migration takes place, what are the consequences of migration, whether India has a migration policy, whether India needs a migration policy, and what type of policy is required. The development and entrenchment of urban slums in India is related to the country's lack of migration policy. A two-pronged policy on migration is thus proposed which would ensure employment opportunities and an improved standard of living in rural areas, while taking into account the planning of cities and city surroundings. Rural areas and small towns need to be provided with more employment opportunities, financial and technological support to process raw materials, infrastructure for agricultural service centers, better education and other facilities to improve local living standards, and the diffusion of industries from big cities to district headquarters and medium-size towns. Commensurate efforts should be made in urban centers to prevent the future development of slums.

From Handpumps to Health: The Evolution of Water and Sanitation Programmes in Bangladesh, India and Nigeria.

ERIC Educational Resources Information Center

Black, Maggie

The case histories of water and sanitation schemes described in this volume can best be understood by identifying the moments at which critical hurdles were encountered and surmounted. The first case study, which concerns Bangladesh, discusses promising prospects that existed amid the pollution and the technical and managerial expansion of the…

Maternal-related deaths and impoverishment among adolescent girls in India and Niger: findings from a modelling study

PubMed Central

Verguet, Stéphane; Nandi, Arindam; Filippi, Véronique; Bundy, Donald A P

2016-01-01

Background High levels of maternal mortality and large associated inequalities exist in low-income and middle-income countries. Adolescent pregnancies remain common, and pregnant adolescent women face elevated risks of maternal mortality and poverty. We examined the distribution across socioeconomic groups of maternal deaths and impoverishment among adolescent girls (15–19 years old) in Niger, which has the highest total fertility rate globally, and India, which has the largest number of maternal deaths. Methods In Niger and India, among adolescent girls, we estimated the distribution per income quintile of: the number of maternal deaths; and the impoverishment, measured by calculating the number of cases of catastrophic health expenditure incurred, caused by complicated pregnancies. We also examined the potential impact on maternal deaths and poverty of increasing adolescent girls' level of education by 1 year. We used epidemiological and cost inputs sourced from surveys and the literature. Results The number of maternal deaths would be larger among the poorer adolescents than among the richer adolescents in Niger and India. Impoverishment would largely incur among the richer adolescents in Niger and among the poorer adolescents in India. Increasing educational attainment of adolescent girls might avert both a large number of maternal deaths and a significant number of cases of catastrophic health expenditure in the 2 countries. Conclusions Adolescent pregnancies can lead to large equity gaps and substantial impoverishment in low-income and middle-income countries. Increasing female education can reduce such inequalities and provide financial risk protection and poverty alleviation to adolescent girls. PMID:27670517

Estimating tuberculosis incidence from primary survey data: a mathematical modeling approach

PubMed Central

Chadha, V. K.; Laxminarayan, R.; Arinaminpathy, N.

2017-01-01

SUMMARY BACKGROUND: There is an urgent need for improved estimations of the burden of tuberculosis (TB). OBJECTIVE: To develop a new quantitative method based on mathematical modelling, and to demonstrate its application to TB in India. DESIGN: We developed a simple model of TB transmission dynamics to estimate the annual incidence of TB disease from the annual risk of tuberculous infection and prevalence of smear-positive TB. We first compared model estimates for annual infections per smear-positive TB case using previous empirical estimates from China, Korea and the Philippines. We then applied the model to estimate TB incidence in India, stratified by urban and rural settings. RESULTS: Study model estimates show agreement with previous empirical estimates. Applied to India, the model suggests an annual incidence of smear-positive TB of 89.8 per 100 000 population (95%CI 56.8–156.3). Results show differences in urban and rural TB: while an urban TB case infects more individuals per year, a rural TB case remains infectious for appreciably longer, suggesting the need for interventions tailored to these different settings. CONCLUSIONS: Simple models of TB transmission, in conjunction with necessary data, can offer approaches to burden estimation that complement those currently being used. PMID:28284250

Litigation as TB Rights Advocacy: A New Delhi Case Study.

PubMed

McBroom, Kerry

2016-06-01

One thousand people die every day in India as a result of TB, a preventable and treatable disease, even though the Constitution of India, government schemes, and international law guarantee available, accessible, acceptable, quality health care. Failure to address the spread of TB and to provide quality treatment to all affected populations constitutes a public health and human rights emergency that demands action and accountability. As part of a broader strategy, health activists in India employ Public Interest Litigation (PIL) to hold the state accountable for rights violations and to demand new legislation, standards for patient care, accountability for under-spending, improvements in services at individual facilities, and access to government entitlements in marginalized communities. Taking inspiration from right to health PIL cases (PILs), lawyers in a New Delhi-based rights organization used desk research, fact-findings, and the Right To Information Act to build a TB PIL for the Delhi High Court, Sanjai Sharma v. NCT of Delhi and Others (2015). The case argues that inadequate implementation of government TB schemes violates the Constitutional rights to life, health, food, and equality. Although PILs face substantial challenges, this paper concludes that litigation can be a crucial advocacy and accountability tool for people living with TB and their allies.

Profile of Home-based Caregivers of Bedridden Patients in North India

PubMed Central

Bains, Puneet; Minhas, Amarjeet Singh

2011-01-01

Background: Caregiving to bedridden patients in India is set to become a major problem in future. Objective: To ascertain the profile of caregivers for the adult bedridden patients in Chandigarh, India. Materials and Methods: This cross-sectional study was conducted on 100 purposively selected bedridden people. The Katz Index of the activities of daily living was used to ascertain their degree of disability. Patients and families were interviewed about the patterns of care provision. Results: The mean age of subjects was 69 years. A majority (68%) of them lived in joint families. All of them required assistance in bathing, dressing, toileting, and transfer. In 54% of the cases someone was hired to look after the subjects. A majority of the caregivers (82%) were family members. All caregivers were untrained. In 35% of the cases unqualified practitioners were consulted, while in 59% of the cases government hospitals were consulted. Most patients (78) were given medicines on time. Complications like urinary tract infection (39%) and pressure ulcers (54%) were reported; 57% of the patients reported satisfaction with the care provided. Conclusion: The main source of caregivers for the bedridden was the family. Bedridden people had high rates of medical complications. There is a need for formal training for the caregivers. PMID:21976795

The growing burden of cancer in India: epidemiology and social context.

PubMed

Mallath, Mohandas K; Taylor, David G; Badwe, Rajendra A; Rath, Goura K; Shanta, V; Pramesh, C S; Digumarti, Raghunadharao; Sebastian, Paul; Borthakur, Bibhuti B; Kalwar, Ashok; Kapoor, Sanjay; Kumar, Shaleen; Gill, Jennifer L; Kuriakose, Moni A; Malhotra, Hemant; Sharma, Suresh C; Shukla, Shilin; Viswanath, Lokesh; Chacko, Raju T; Pautu, Jeremy L; Reddy, Kenipakapatnam S; Sharma, Kailash S; Purushotham, Arnie D; Sullivan, Richard

2014-05-01

Cancer can have profound social and economic consequences for people in India, often leading to family impoverishment and societal inequity. Reported age-adjusted incidence rates for cancer are still quite low in the demographically young country. Slightly more than 1 million new cases of cancer are diagnosed every year in a population of 1.2 billion. In age-adjusted terms this represents a combined male and female incidence of about a quarter of that recorded in western Europe. However, an estimated 600,000-700,000 deaths in India were caused by cancer in 2012. In age-standardised terms this figure is close to the mortality burden seen in high-income countries. Such figures are partly indicative of low rates of early-stage detection and poor treatment outcomes. Many cancer cases in India are associated with tobacco use, infections, and other avoidable causes. Social factors, especially inequalities, are major determinants of India's cancer burden, with poorer people more likely to die from cancer before the age of 70 years than those who are more affluent. In this first of three papers, we examine the complex epidemiology of cancer, the future burden, and the dominant sociopolitical themes relating to cancer in India. Copyright © 2014 Elsevier Ltd. All rights reserved.

DNA evidence: current perspective and future challenges in India.

PubMed

Verma, Sunil K; Goswami, Gajendra K

2014-08-01

Since the discovery of DNA fingerprinting technology in 1985 it has been used extensively as evidence in the court of law world-wide to establish the individual identity both in civil and criminal matters. In India, the first case of parentage dispute solved by the use of DNA fingerprinting technology was in 1989. Since then till date, the DNA technology has been used not only to resolve the cases of paternity and maternity disputes, but also for the establishment of individual identity in various criminal cases and for wildlife forensic identification. Since last half a decade, India is exercising to enact legislation on the use of DNA in the judicial realm and the draft 'Human DNA Bill-2012' is pending in the parliament. Largely, the promoters of forensic DNA testing have anticipated that DNA tests are nearly infallible and DNA technology could be the greatest single advance step in search for truth, conviction of the perpetrator, and acquittal of the innocent. The current article provides a comprehensive review on the status of DNA testing in India and elucidates the consequences of the admissibility of DNA as 'evidence' in the judicial dominion. In this backdrop of civil and criminal laws and changing ethical and societal attitudes, it is concluded that the DNA legislation in India and world-wide needs to be designed with utmost care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Curriculum Development in Literacy. Monograph No. 1. Part A: Proceedings and Methods of the First Regional Literacy Workshop (Udaipur, India, November 29-December 20, 1979). Part B: Curriculum Development in Literacy. Literacy Curriculum and Materials Development. Portfolio of Literacy Materials. Series I: Four Monographs.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Regional Office for Education in Asia and the Pacific.

This monograph, one of four in a series, contains material on a particular aspect of literacy training. Developed from reports, papers, and case studies from the Regional Literacy Workshop (November 29-December 20, 1979) held in Udaipur, India, the monographs are suggested for use in training programs for literacy personnel as background…

Legal hurdles for gastroenterologists in India.

PubMed

Nagpal, Neeraj

2017-05-01

Litigation and compensation claims have started occurring with increasing frequency against gastroenterologists in India. A study of few such cases decided by Indian Courts shows that commonest reason for allegations of negligence being upheld by Indian Courts is an improper consent being taken. Professional organisations need to focus on these issues more aggressively than has been done in the past. Judgments which do not appear to be in conformity with standard medical practices need to be challenged in higher courts, failing in which they would become precedents for future similar judgments.

Perceived mental health related stigma, gender, and depressive symptom severity in a psychiatric facility in South India.

PubMed

Kulesza, Magdalena; Raguram, R; Rao, Deepa

2014-06-01

Few studies exist on the topic of gender associated with depression and mental health-related stigma coming out of non-Western countries such as India. We aimed to add to the literature by assessing these relationships among adults seeking psychiatric services in India. Participants were 60 individuals seeking care at a psychiatric clinic in Bangalore, India. The majority of participants were female with a mean age of 36 years (SD=9.75). Contrary to our prediction, there were no significant differences between men (M=28.96; SD=9.85) and women (M=33.03; SD=12.08) on depression severity, t(58)=1.42, p=.16. Yet, women (M=10.09, SD=8.23) reported significantly more perceived stigma than men (M=5.79, SD=5.86), t(58)=2.30, p=.02. While men and women seeking psychiatric services at the psychiatric clinic in India report similar levels of depression severity, women reported more perceived mental illness stigma. Having experienced regular forms of discrimination associated with female status in India, it may be the case that women are more attuned to other forms of stigma, such as mental health stigma investigated in the present study. Given the detrimental impact of stigma on treatment adherence and engagement in care, additional research is needed support this work, including research on interventions to reduce stigma and improve engagement in care. Copyright © 2014 Elsevier B.V. All rights reserved.

WHO says Indian AIDS funds misused.

PubMed

1994-10-03

Funds provided to India to promote AIDS awareness have been misused, in some instances by interstate truck drivers, targeted by studies as a potential source of spreading HIV, who use free condoms to plug leaking radiators on their trucks, a World Health Organization (WHO) report said. There has been an increasing demand for free condoms distributed by the government, but they weren't used to promote safe sex. Prostitution in Bombay has flourished into a major service industry. A study in 1993 by WHO revealed 35% of the city's prostitutes tested HIV-positive. Despite the fact that AIDS had spread throughout India, local and state governments were lagging behind in using funds to promote protection against HIV. In 1992, the World Bank loaned $84 million to India to finance its anti-AIDS program, but where a state government was actually using the money, it was either under-used or misused. According to the National AIDS Control Organization, India has 1.62 million HIV-positive cases, up by 60% since 1993. Most hospitals in India still have no blood screening facilities and many refuse to treat HIV-positive patients. Nearly 50 to 60% of blood in the country is not yet screened for HIV, the head of a non-governmental health organization said. Officials, however, balk at the thought of educating a country with the second largest population in the world, rampant illiteracy, and sexual taboos. India's socioeconomic conditions act as a major barrier to controlling AIDS and enforcing laws in regard to HIV-positive patients.

The number of privately treated tuberculosis cases in India: an estimation from drug sales data.

PubMed

Arinaminpathy, Nimalan; Batra, Deepak; Khaparde, Sunil; Vualnam, Thongsuanmung; Maheshwari, Nilesh; Sharma, Lokesh; Nair, Sreenivas A; Dewan, Puneet

2016-11-01

Understanding the amount of tuberculosis managed by the private sector in India is crucial to understanding the true burden of the disease in the country, and thus globally. In the absence of quality surveillance data on privately treated patients, commercial drug sales data offer an empirical foundation for disease burden estimation. We used a large, nationally representative commercial dataset on sales of 189 anti-tuberculosis products available in India to calculate the amount of anti-tuberculosis treatment in the private sector in 2013-14. We corrected estimates using validation studies that audited prescriptions against tuberculosis diagnosis, and estimated uncertainty using Monte Carlo simulation. To address implications for numbers of patients with tuberculosis, we explored varying assumptions for average duration of tuberculosis treatment and accuracy of private diagnosis. There were 17·793 million patient-months (95% credible interval 16·709 million to 19·841 million) of anti-tuberculosis treatment in the private sector in 2014, twice as many as the public sector. If 40-60% of private-sector tuberculosis diagnoses are correct, and if private-sector tuberculosis treatment lasts on average 2-6 months, this implies that 1·19-5·34 million tuberculosis cases were treated in the private sector in 2014 alone. The midpoint of these ranges yields an estimate of 2·2 million cases, two to three times higher than currently assumed. India's private sector is treating an enormous number of patients for tuberculosis, appreciably higher than has been previously recognised. Accordingly, there is a re-doubled need to address this burden and to strengthen surveillance. Tuberculosis burden estimates in India and worldwide require revision. Bill & Melinda Gates Foundation. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Natural disaster management in India with focus on floods and cyclones

NASA Astrophysics Data System (ADS)

Thattai, Deeptha V.; Sathyanathan, R.; Dinesh, R.; Harshit Kumar, L.

2017-07-01

Disasters are of two major kinds, natural and manmade, and affect the community. Natural disasters are caused by natural earth processes like floods, droughts, cyclones, tsunamis, earthquakes and epidemics. Manmade disasters occur due to chemical spills, accidents, terrorism activities etc. India is prone to almost all the major natural disasters. The high population density combined with poor preparedness, planning and management, and rescue and relief measures inevitably lead to huge losses of lives and property every year in the country. This paper analyses the disaster management policy of India and its implementation using two recent case studies - one where a relative degree of success has been achieved (cyclones) and the other where we are still struggling to have even a basic preparedness system in place (floods).

Forensic investigation into a death: post-traumatic amnesia in a worker with a work-related head injury sustained in a coal-fired thermal power plant in India.

PubMed

Muralidhar, Venkiteswaran

2017-03-15

This is the first reported case of a work-related head injury in a coal-fired thermal power plant in India. This case highlights the trend of not reporting work injuries due to fears of reprisal from the management team that may include the termination of employment. Post-traumatic amnesia in a worker presenting with head trauma must be recognised by coworkers, so the cause of injury can be elicited early and the victim gets timely medical help. There are few published studies on work-related traumatic brain injury, and they provide no information on either anatomical localisation or signs and symptoms. It is imperative that this under-researched area is studied, so detailed epidemiology and accurate national and global statistics are made available to address this dangerous yet preventable condition. 2017 BMJ Publishing Group Ltd.

Risk factors of breast cancer among women in eastern India: a tertiary hospital based case control study.

PubMed

Das, Soumen; Sen, Santanu; Mukherjee, Anindya; Chakraborty, Debadatta; Mondal, Pankaj Kumar

2012-01-01

Breast cancer is one of the most common cancers of women in India with high fatality rate. Over a 1 year study period 105 consecutive biopsy or fine needle aspiration cytology confirmed breast cancer patients were interviewed by direct questionnaire method regarding risk factors attending Surgery and Radiotherapy OPD of Medical College Kolkata, West Bengal while taking other 105 patients attending Surgery Department for some other disease as controls. The data were compiled in MS Excel 2007 and analyzed by Epi info 3.5.1 software. Among the cases, rural residence, illiteracy and low socio-economic status was significantly higher than controls. Late onset of menarche, late onset of menopause, ever OCP usage, breast feeding for 1-2 years and age of 1st childbirth between 20-30 years were found to be significant protective factors. People should be made aware regarding the modifiable risk factors to prevent breast cancer.

Impact of chronic lymphatic filariasis on quantity and quality of productive work among weavers in an endemic village from India.

PubMed

Babu, B V; Swain, B K; Rath, K

2006-05-01

To assess the impact of hydrocele and lymphoedema on the quantity and quality of productive work of weavers. Case-control study in an endemic village in Andhra Pradesh, India. We collected qualitative data on work activities from cases and age- and sex-matched controls through informal discussions and observation. The mean (+/-standard deviation) daily work time of cases was 7.38 h (+/-2.47), significantly less than that of controls (8.17+/-2.41 h). Lost work time was equivalent to around 29 days of work in a year. Gender had significant influence on the mean number of working hours in this occupational group. Most cases could not weave, which is physically demanding, and preferred less strenuous tasks such as spinning, starching, dyeing or sizing. Hard physical labour constitutes 71.5% of total work time among patients and 83.7% in controls. As income also depends on the type of work, cases earn less. Filariasis has an adverse impact on the productivity of weavers, and morbidity management strategies and control programmes need to take this into account.

Vaccine-associated paralytic poliomyelitis in India during 1999: decreased risk despite massive use of oral polio vaccine.

PubMed Central

Kohler, Kathryn A.; Banerjee, Kaushik; Gary Hlady, W.; Andrus, Jon K.; Sutter, Roland W.

2002-01-01

OBJECTIVE: Vaccine-associated paralytic poliomyelitis (VAPP) is a rare but serious consequence of the administration of oral polio vaccine (OPV). Intensified OPV administration has reduced wild poliovirus transmission in India but VAPP is becoming a matter of concern. METHODS: We analysed acute flaccid paralysis (AFP) surveillance data in order to estimate the VAPP risk in this country. VAPP was defined as occurring in AFP cases with onset of paralysis in 1999, residual weakness 60 days after onset, and isolation of vaccine-related poliovirus. Recipient VAPP cases were a subset with onset of paralysis between 4 and 40 days after receipt of OPV. FINDINGS: A total of 181 AFP cases met the case definition. The following estimates of VAPP risk were made: overall risk, 1 case per 4.1 to 4.6 million OPV doses administered; recipient risk,1 case per 12.2 million; first-dose recipient risk, 1 case per 2.8 million; and subsequent-dose recipient risk, 1 case per 13.9 million. CONCLUSION: On the basis of data from a highly sensitive surveillance system the estimated VAPP risk in India is evidently lower than that in other countries, notwithstanding the administration of multiple OPV doses to children in mass immunization campaigns. PMID:11984607

Biogeochemical study of termite mounds: a case study from Tummalapalle area of Andhra Pradesh, India.

PubMed

Arveti, Nagaraju; Reginald, S; Kumar, K Sunil; Harinath, V; Sreedhar, Y

2012-04-01

Termite mounds are abundant components of Tummalapalle area of uranium mineralization of Cuddapah District of Andhra Pradesh, India. The systematic research has been carried out on the application of termite mound sampling to mineral exploration in this region. The distribution of chemical elements Cu, Pb, Zn, Ni, Co, Cr, Li, Rb, Sr, Ba, and U were studied both in termite soils and adjacent surface soils. Uranium accumulations were noticed in seven termite mounds ranging from 10 to 36 ppm. A biogeochemical parameter called "Biological Absorption Coefficient" of the termite mounds indicated the termite affected soils contained huge amounts of chemical elements than the adjacent soils.

Drug poisoning in the community among children: a nine years' experience from a tertiary care center in south India.

PubMed

Winston A, Blessed; Das Adhikari, Debasis; Das, Saibal; Vazhudhi, Kaysina; Kumar, Aniket; Shanthi Fx, Margaret; Agarwal, Indira

2017-02-01

This study was performed to determine the incidence, demographic distribution, types and outcomes across various drug poisonings among children from south India. This retrospective study included children less than 16 years who presented to the Pediatric Emergency Department with drug poisoning from the 1st of October 2004 to the 30th of September 2013. Out of the total 997 poisoning cases, 366 (36.71%) were contributed by drugs; mainly antiepileptics, central nervous system depressants, psychotropics, analgesic-antipyretics and natural drugs. Males and children of < 5 years were mostly affected. Although many children developed complications and required intensive care unit admissions, the total mortality rate was less than 1%. The incidence of drug poisoning showed a decreasing trend over the last 4 years. This study for the first time gives an elaborative insight into pediatric drug poisoning over a nine-year period from a Pediatric Emergency Department tertiary care center in south India.

Multi-center surveillance for pneumonia & meningitis among children (<2 yr) for Hib vaccine probe trial preparation in India.

PubMed

Gupta, Madhu; Kumar, Rajesh; Deb, Alok Kumar; Bhattacharya, Sujit Kumar; Bose, Anuradha; John, Jacob; Balraj, Vinohar; Ganguly, N K; Kant, Lalit; Kapoor, Ambujam Nair; Watt, James; Shearer, Jessica; Santosham, Mathuram

2010-05-01

Severe clinical pneumonia and meningitis caused by Haemophilus influenzae type b in children less than 5 yr old is preventable by use of Hib vaccine. However, data on Hib burden in India are limited. To support an evidence-based decision for Hib vaccine introduction in India, a vaccine probe study was planned. This paper presents the results of the preparatory phase for such a study, which aimed to determine the feasibility of conducting a randomized vaccine probe study and to estimate the incidence of all causes of pneumonia and meningitis. The preparatory study included population- based, hospital-based and carriage surveillance. Children aged 18-24 months and were enrolled at PGIMER, Chandigarh, CMC, Vellore and NICED, Kolkata, from July 2005 to December 2006. At the time of enrollment, parents were informed about the signs and symptoms of pneumonia and meningitis, and were encouraged to take the child to study hospitals for treatment. Hospitalized children less than two years of age suspected of having pneumonia and/or meningitis were enrolled in study hospitals, whether or not they were from the cohort population. Patients were examined clinically and received chest radiograph for suspected cases of pneumonia or lumbar puncture for suspected cases of meningitis. Blood culture was done for both pneumonia and meningitis patients. Cerebrospinal fluid (CSF) was tested for biochemistry, culture, latex agglutination test and polymerase chain reaction. Nasopharyngeal swabs were collected from healthy children less than 2 yr of age at immunization clinics to estimate Hib carriage. A cohort of 17,951 children were recruited for the population-based arm. The incidence of severe clinical pneumonia ranged from 2717 to 7890 per 100,000 child-years of observation; suspected meningitis ranged from 1971 to 2433 per 100,000 child-years of observation. In the hospital-based study 7/90 (7.8%), 29/98 (29.6%) and 38/181 (21.0%) of CSF samples with cell count > or =100 WBCs/mm(3); were purulent at Chandigarh, Kolkata and Vellore respectively. Of these purulent CSF samples, Hib was detected in 2, 6 and 11 cases, respectively. The Hib nasopharyngeal carriage prevalence ranged from 6.0 - 7.6 per cent. Incidence of severe clinical pneumonia is comparable with other studies from India but that of suspected meningitis is higher. Although rates of Hib meningitis cannot be calculated from a hospital-based study, there is evidence of Hib meningitis in these study settings. Hib carriage prevalence indicates that Hib is present and circulating in these study areas. There is a significant burden of pneumonia and meningitis among children in India. Continued strengthening of laboratory capacity and bacterial surveillance systems are necessary.

Group B Streptococcal Colonization Among Pregnant Women in Delhi, India.

PubMed

Chaudhary, Manu; Rench, Marcia A; Baker, Carol J; Singh, Pushpa; Hans, Charoo; Edwards, Morven S

2017-07-01

Little is known regarding maternal group B streptococcal (GBS) colonization prevalence and capsular (CPS) serotype distribution among pregnant women in India. The objective of this prospective cohort study was to determine GBS recto-vaginal colonization prevalence in pregnant women at Dr. Ram Manohar Lohia Hospital in Delhi, India. Literature review identified reports from India assessing GBS colonization prevalence in pregnant women. Rectal and vaginal swabs were inoculated into Strep B Carrot Broth (Hardy Diagnostics, Santa Maria, CA) and subcultured onto GBS Detect plates (Hardy Diagnostics, Santa Maria, CA). Isolates were serotyped using ImmuLex Strep-B latex kits (Statens Serum Institut, Copenhagen, Denmark). Thirteen studies were identified citing GBS colonization prevalence during pregnancy as 0.47%-16%. Among 300 pregnant women (mean age: 26.9 years; mean gestation: 34 weeks) enrolled (August 2015 to April 2016), GBS colonization prevalence was 15%. Fifteen percent of women had vaginal only, 29% had rectal only and 56% had both sites colonized. CPS types were Ia (13.3%), Ib (4.4%), II (20%), III (22.2%), V (20%) and VII (6.7%); 13.3% were nontypable. Fetal loss in a prior pregnancy at ≥20-weeks gestation was more common in colonized than noncolonized women (15.6% vs. 3.5%; P = 0.004). Employing recent census data for the birth cohort and estimating that 1%-2% of neonates born to colonized women develop early-onset disease, at least 39,000 cases of early-onset disease may occur yearly in India. Using optimal methods, 15% of third trimester pregnant women in India are GBS colonized. A multivalent vaccine containing 6 CPS types (Ia, Ib, II, III, V and VII) would encompass ~87% of GBS carried by pregnant women in India.

Cardiovascular Diseases in India: Current Epidemiology and Future Directions.

PubMed

Prabhakaran, Dorairaj; Jeemon, Panniyammakal; Roy, Ambuj

2016-04-19

Cardiovascular diseases (CVDs) have now become the leading cause of mortality in India. A quarter of all mortality is attributable to CVD. Ischemic heart disease and stroke are the predominant causes and are responsible for >80% of CVD deaths. The Global Burden of Disease study estimate of age-standardized CVD death rate of 272 per 100 000 population in India is higher than the global average of 235 per 100 000 population. Some aspects of the CVD epidemic in India are particular causes of concern, including its accelerated buildup, the early age of disease onset in the population, and the high case fatality rate. In India, the epidemiological transition from predominantly infectious disease conditions to noncommunicable diseases has occurred over a rather brief period of time. Premature mortality in terms of years of life lost because of CVD in India increased by 59%, from 23.2 million (1990) to 37 million (2010). Despite wide heterogeneity in the prevalence of cardiovascular risk factors across different regions, CVD has emerged as the leading cause of death in all parts of India, including poorer states and rural areas. The progression of the epidemic is characterized by the reversal of socioeconomic gradients; tobacco use and low fruit and vegetable intake have become more prevalent among those from lower socioeconomic backgrounds. In addition, individuals from lower socioeconomic backgrounds frequently do not receive optimal therapy, leading to poorer outcomes. Countering the epidemic requires the development of strategies such as the formulation and effective implementation of evidence-based policy, reinforcement of health systems, and emphasis on prevention, early detection, and treatment with the use of both conventional and innovative techniques. Several ongoing community-based studies are testing these strategies. © 2016 American Heart Association, Inc.

Branding to treat jaundice in India.

PubMed

John, Selva Inita; Balekuduru, Ainash; Zachariah, Uday; Eapen, C E; Chandy, George

2009-01-01

Jaundice is regarded as a mysterious disease rather than a symptom of disease in several parts of India. We describe 8 cases that underwent branding to treat jaundice and subsequently presented to our centre. The causes for jaundice in these patients included a variety of benign and malignant disorders. Our report suggests that despite being literate, strong cultural beliefs lead people to seek potentially harmful procedures like branding to treat jaundice in parts of India.

Mental illness, poverty and stigma in India: a case-control study.

PubMed

Trani, Jean-Francois; Bakhshi, Parul; Kuhlberg, Jill; Narayanan, Sreelatha S; Venkataraman, Hemalatha; Mishra, Nagendra N; Groce, Nora E; Jadhav, Sushrut; Deshpande, Smita

2015-02-23

To assess the effect of experienced stigma on depth of multidimensional poverty of persons with severe mental illness (PSMI) in Delhi, India, controlling for gender, age and caste. Matching case (hospital)-control (population) study. University Hospital (cases) and National Capital Region (controls), India. A case-control study was conducted from November 2011 to June 2012. 647 cases diagnosed with schizophrenia or affective disorders were recruited and 647 individuals of same age, sex and location of residence were matched as controls at a ratio of 1:2:1. Individuals who refused consent or provided incomplete interview were excluded. Higher risk of poverty due to stigma among PSMI. 38.5% of PSMI compared with 22.2% of controls were found poor on six dimensions or more. The difference in multidimensional poverty index was 69% between groups with employment and income of the main contributors. Multidimensional poverty was strongly associated with stigma (OR 2.60, 95% CI 1.27 to 5.31), scheduled castes/scheduled tribes/other backward castes (2.39, 1.39 to 4.08), mental illness (2.07, 1.25 to 3.41) and female gender (1.87, 1.36 to 2.58). A significant interaction between stigma, mental illness and gender or caste indicates female PSMI or PSMI from 'lower castes' were more likely to be poor due to stigma than male controls (p<0.001) or controls from other castes (p<0.001). Public stigma and multidimensional poverty linked to SMI are pervasive and intertwined. In particular for low caste and women, it is a strong predictor of poverty. Exclusion from employment linked to negative attitudes and lack of income are the highest contributors to multidimensional poverty, increasing the burden for the family. Mental health professionals need to be aware of and address these issues. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Diagnosis of Dementia by Machine learning methods in Epidemiological studies: a pilot exploratory study from south India.

PubMed

Bhagyashree, Sheshadri Iyengar Raghavan; Nagaraj, Kiran; Prince, Martin; Fall, Caroline H D; Krishna, Murali

2018-01-01

There are limited data on the use of artificial intelligence methods for the diagnosis of dementia in epidemiological studies in low- and middle-income country (LMIC) settings. A culture and education fair battery of cognitive tests was developed and validated for population based studies in low- and middle-income countries including India by the 10/66 Dementia Research Group. We explored the machine learning methods based on the 10/66 battery of cognitive tests for the diagnosis of dementia based in a birth cohort study in South India. The data sets for 466 men and women for this study were obtained from the on-going Mysore Studies of Natal effect of Health and Ageing (MYNAH), in south India. The data sets included: demographics, performance on the 10/66 cognitive function tests, the 10/66 diagnosis of mental disorders and population based normative data for the 10/66 battery of cognitive function tests. Diagnosis of dementia from the rule based approach was compared against the 10/66 diagnosis of dementia. We have applied machine learning techniques to identify minimal number of the 10/66 cognitive function tests required for diagnosing dementia and derived an algorithm to improve the accuracy of dementia diagnosis. Of 466 subjects, 27 had 10/66 diagnosis of dementia, 19 of whom were correctly identified as having dementia by Jrip classification with 100% accuracy. This pilot exploratory study indicates that machine learning methods can help identify community dwelling older adults with 10/66 criterion diagnosis of dementia with good accuracy in a LMIC setting such as India. This should reduce the duration of the diagnostic assessment and make the process easier and quicker for clinicians, patients and will be useful for 'case' ascertainment in population based epidemiological studies.

Epidemiology of Parkinson disease in the city of Kolkata, India

PubMed Central

Das, S.K.; Misra, A.K.; Ray, B.K.; Hazra, A.; Ghosal, M.K.; Chaudhuri, A.; Roy, T.; Banerjee, T.K.; Raut, D.K.

2010-01-01

Objective: No well-designed longitudinal study on Parkinson disease (PD) has been conducted in India. Therefore, we planned to determine the prevalence, incidence, and mortality rates of PD in the city of Kolkata, India, on a stratified random sample through a door-to-door survey. Method: This study was undertaken between 2003 to 2007 with a validated questionnaire by a team consisting of 4 trained field workers in 3 stages. Field workers screened the cases, later confirmed by a specialist doctor. In the third stage, a movement disorders specialist undertook home visits and reviewed all surviving cases after 1 year from last screening. Information on death was collected through verbal autopsy. A nested case-control study (1:3) was also undertaken to determine putative risk factors. The rates were age adjusted to the World Standard Population. Result: A total population of 100,802 was screened. The age-adjusted prevalence rate (PR) and average annual incidence rate were 52.85/100,000 and 5.71/100,000 per year, respectively. The slum population showed significantly decreased PR with age compared with the nonslum population. The adjusted average annual mortality rate was 2.89/100,000 per year. The relative risk of death was 8.98. The case-control study showed that tobacco chewing protected and hypertension increased PD occurrence. Conclusion: This study documented lower prevalence and incidence of PD as compared with Caucasian and a few Oriental populations. The mortality rates were comparable. The decreased age-specific PR among slum populations and higher relative risk of death need further probing. GLOSSARY AAIR = average annual incidence rate; AAMR = average annual mortality rate; CI = confidence interval; FSQ = family screening questionnaire; ICC = intraclass correlation coefficient; IR = incidence rate; MD = movement disorder; NSSO = National Sample Survey Organization; OR = odds ratio; PD = Parkinson disease; PPS = parkinsonism plus syndrome; PR = prevalence rate; PRM = Poisson regression modeling; RR = relative risk; SP = secondary parkinsonism; VA = verbal autopsy. PMID:20938028

The impact of TRIPS on innovation and exports: a case study of the pharmaceutical industry in India.

PubMed

Malhotra, Prabodh

2008-01-01

Currently, there is a debate on what impact the implementation of the Trade Related Aspects of Intellectual Property Rights (TRIPS) in India would have on its pharmaceutical industry and health care. The debate hinges primarily on two major questions. First, will the new patent regime provide an impetus for innovation in the pharmaceutical industry? Second, how far will India's pharmaceutical exports of copied versions of patented drugs to developing countries be restricted under the new regime? The first question seeks to find out if TRIPS will increase India's innovative capabilities to fill the current vacuum to develop drugs for tropical diseases. The large multinational companies (MNCs) that dominate the global pharmaceutical industry have no interest in commercial ventures that have little potential for great returns on investment. The second question attempts to find a solution to the lack of access to medicine in most developing countries. Indian manufacturers' supply of reverse-engineered drugs, which cost only a fraction of the prices charged by MNCs, may be coming to an end under the new regime. Against this backdrop, this article attempts to analyse the impact of strengthening intellectual property rights in India.

Sexual Behavior and Condom Use among Seasonal Dalit Migrant Laborers to India from Far West, Nepal: A Qualitative Study

PubMed Central

Bam, Kiran; Thapa, Rajshree; Newman, Marielle Sophia; Bhatt, Lokesh Prasad; Bhatta, Shree Krishna

2013-01-01

Background Around 41% of Human Immunodeficiency Virus (HIV) cases in Nepal occur in seasonal migrant laborers. Dalit migrant laborers represent the largest proportion of reported HIV cases in the Far Western Region (Sudur Pashchimanchal, or Far West), Nepal. The study’s objectives were to assess sexual behavior, condom use status and HIV risk perception among Dalit migrant laborers to India from Far West Region, Nepal. Methods The study was conducted among Dalit male migrant laborers aged 15 years and above who had migrated for at least six months of the last two years to India. For the sampling the village development committees (VDCs) from Achham, Doti and Kanchanpur districts of Nepal were purposively selected. The data were collected in March and April 2011 via ten in-depth interviews and four focus group discussions and analyzed using content analysis. Results Poor socio-economic status, caste-related discrimination, and lack of employment opportunities push large groups of young Dalits to migrate to India for employment, where they engage in sex with female sex workers (FSWs). The participants described unmarried status, peer influence, alcohol use, low-priced sex with FSWs and unwillingness to use condoms as common factors of their migration experience. Lack of awareness on HIV/AIDS was common among study participants. Awareness of HIV/AIDS and faithful, monogamous partnerships are reported as factors influencing safer sexual behavior. Conclusions Dalits are an especially vulnerable population among migrant laborers and may be over-represented in new HIV infections in Nepal. Comprehensive surveying and health promotion programs targeted to this population are urgently needed and potent methods of stopping HIV spread. PMID:24040359

Sociodemographic characteristics and aggression quotient among children in conflict with the law in India: A case-control study.

PubMed

Gupta, Archit; Biddala, Ooha Susmita; Dwivedi, Mandavi; Variar, Prathyaksha; Singh, Aparna; Sen, Soham; Bhat, P Shivaram; Kunte, Renuka; Nair, Velu; Shankar, Subramanian

2015-01-01

The incidence of juvenile delinquency has increased in the past decade in India and juvenile crimes are increasingly being reported. This has been attributed to many biopsychosocial factors. It is essential to understand these issues in the context of India to determine the response of acts of children in conflict with the law. We aimed to assess the sociodemographic characteristics and the aggression quotient of children in conflict with the law (juvenile delinquents) in observation homes across India and compare them with those who were not. We did a case-control study in five juvenile homes in the cities of Hyderabad, Lucknow and Pune. Ninety inmates (74 boys, 16 girls) were included in the study. Sociodemographic characteristics and aggression quotient of children in conflict with the law were evaluated using two separate questionnaires, i.e. a sociodemographic questionnaire and the modified Buss and Perry aggression questionnaire. These were compared with a control group of similar age, sex and income status. All the children in conflict with the law surveyed belonged to the lower socioeconomic strata, had a significantly higher chance (p<0.05) of coming from broken homes, have addictions, jailed family members and suffered physical and sexual abuse than controls. They also scored higher on all domains of the aggression questionnaire than controls. A collection of sociodemographic attributes such as broken homes, addictions and abuse seem to have an important association with juvenile delinquency. Children in conflict with the law are also more likely to be associated with a higher aggression quotient as compared to children who were not. Copyright 2015, NMJI.

Branding in children: a barbaric practice still exists in India.

PubMed

Patra, Pratap Kumar

2016-01-01

Branding is an inhuman traditional practice most commonly employed to treat various disorders in neonates and children in certain community in India. Though stringent law exists to prevent such harmful practices, cases of branding is not uncommon in current era.

Thyroiditis: a Clinico-cytomorphological Study with a Reference to the Ethnic Groups of Northeast Regions of India.

PubMed

Kalita, Abhijit; Baruah, Ronica

2015-12-01

Definite clinico-cytological criterion is outlined for thyroid lesions. Fine needle aspiration cytology (FNAC) makes it easier to segregate cases of thyroiditis (Chronic lymphocytic thyroiditis/Hashimoto's thyroiditis-CLT/HT, and subacute thyroiditis-SAT) from other benign and malignant lesions of thyroid. The study was done for a period of 5½ years at a diagnostic centre in Guwahati. Patients underwent FNAC and smears were studied for cytomorphology. A correlation with clinical features and thyroid function, including antithyroid antibody estimation, was done, wherever possible. 792 thyroid lesions were encountered during the study, of which 213 (26.89 %) were cases of thyroiditis (70.43 % CLT/HT, 24.9 % SAT and 3.76 % having overlapping features of CLT/HT and SAT); 2 cases (0.9 %) of CLT showed suspicion of Non-Hodgkin's Lymphoma (NHL), which was confirmed on histopathology. 24 cases (11.26 %) belonged to different ethnic tribal groups of Northeast India. CLT/HT presented predominantly with diffuse thyroid enlargement, but 12 cases (8 % of CLT/HT cases) had nodular enlargement. Patients presented with predominantly hypothyroidism; however occasional hyperthyroid cases were also seen. SAT showed signs of inflammation and presented with hyperthyroidism. Overlap cases of CLT/HT and SAT showed combined clinico-cytomorphological features of both lesions. 37.5 % cases with overlapping features belonged to tribal communities. A rise in incidence of thyroiditis, particularly CLT/HT, was seen. Overlap features of CLT/HT and SAT was noticed in significant percentage. No bias was noticed amongst any specific tribal community. FNAC, coupled with clinico-serological study, helps to diagnose thyroiditis at early stage.

HIV-associated hematologic malignancies: Experience from a Tertiary Cancer Center in India.

PubMed

Reddy, Rakesh; Gogia, Ajay; Kumar, Lalit; Sharma, Atul; Bakhshi, Sameer; Sharma, Mehar C; Mallick, Saumyaranjan; Sahoo, Ranjit

2016-01-01

Data on HIV associated hematologic malignancies is sparse from India. This study attempts to analyze the spectrum and features of this disease at a tertiary cancer center in India. Retrospective study from case records of patients registered with a diagnosis of hematologic malignancy and HIV infection between January 2010 and June 2015. Thirteen cases of HIV associated hematologic malignancies were identified, six of them pediatric. HIV diagnosis was concurrent to diagnosis of cancer in 12 and preceded it in one of them. ECOG PS at presentation was >1 in all of them. All patients, except one, had B symptoms. Six of the patients had bulky disease and six are stage 4. Predominant extranodal disease was seen in 67% of them. NHL accounted for 10 of 13 patients and DLBCL-Germinal center was the most common subtype. Mean CD4+ cell count was 235/μL (range, 32-494). HAART could be given along with chemotherapy to 11 patients. Two-thirds of patients received standard doses of therapy. Chemo-toxicity required hospitalization in 58%. CR was achieved in 45% and 36% had progressive disease with first-line therapy. At the time of last follow up, 3 patients were alive with responsive disease, 2 in CR and 1 in PR. None of the pediatric patients were long time responders. These malignancies were of advanced stage and higher grade. Goal of therapy, in the HAART era, is curative. Pediatric patients had dismal outcome despite good chemotherapy and HAART. There is an urgent need to improve data collection for HIV related cancers in India.

Zika reveals India's risk communication challenges and needs.

PubMed

Vijaykumar, Santosh; Raamkumar, Aravind Sesagiri

2018-04-12

India's approach to disseminating information about the first three cases of the Zika virus was criticised nationally and internationally after the issue came to light in May 2017 through a World Health Organization news release. We analyse the incident from a risk communication perspective. This commentary recaps the events and synthesises key arguments put forth by the news media and public health stakeholders. We use Peter Sandman's risk = hazard + outrage framework - also adopted by India's risk communication planners - to analyse India's risk communication response and contextualise it against the mandate of the National Risk Communication Plan and Integrated Disease Surveillance Programme. We conclude with recommendations for India's risk communication policymakers, including the need to develop capacity for risk communication research and scholarship in the country.

Nosocomial infection of CCHF among health care workers in Rajasthan, India.

PubMed

Yadav, Pragya D; Patil, Deepak Y; Shete, Anita M; Kokate, Prasad; Goyal, Pulkit; Jadhav, Santosh; Sinha, Sanjeev; Zawar, Divya; Sharma, Surendra K; Kapil, Arti; Sharma, D K; Upadhyay, Kamlesh J; Mourya, Devendra T

2016-11-03

Ever since Crimean-Congo hemorrhagic fever [CCHF] discovered in India, several outbreaks of this disease have been recorded in Gujarat State, India. During the year 2011 to 2015 several districts of Gujarat and Rajasthan state (Sirohi) found to be affected with CCHF including the positivity among ticks and livestock. During these years many infected individuals succumbed to this disease; which subsequently led to nosocomial infections. Herein, we report CCHF cases recorded from Rajasthan state during January 2015. This has affected four individuals apparently associated with one suspected CCHF case admitted in a private hospital in Jodhpur, Rajasthan. A 30-year-old male was hospitalized in a private hospital in Jodhpur, Rajasthan State, who subsequently had developed thrombocytopenia and showed hemorrhagic manifestations and died in the hospital. Later on, four nursing staff from the same hospital also developed the similar symptoms (Index case and Case A, B, C). Index case succumbed to the disease in the hospital at Jodhpur followed by the death of the case A that was shifted to AIIMS hospital, Delhi due to clinical deterioration. Blood samples of the index case and Case A, B, C were referred to the National institute of Virology, Pune, India for CCHF diagnosis from the different hospitals in Rajasthan, Delhi and Gujarat. However, a sample of deceased suspected CCHF case was not referred. Subsequently, blood samples of 5 nursing staff and 37 contacts (Case D was one of them) from Pokhran area, Jaisalmer district were referred to NIV, Pune. It clearly indicated that nursing staff acquired a nosocomial infection while attending the suspected CCHF case in an Intensive Care Unit of a private hospital in Jodhpur. However, one case was confirmed from the Pokhran area where the suspected CCHF case was residing. This case might have got the infection from suspected CCHF case or through other routes. CCHF strain associated with these nosocomial infections shares the highest identity with Afghanistan strain and its recent introduction from Afghanistan cannot be ruled out. However, lack of active surveillance, unawareness among health care workers leads to such nosocomial infections.

Gelatinous Marrow Transformation: A Series of 11 Cases from a Tertiary Care Centre in South India

PubMed Central

Das, Sreeya; Mishra, Pritinanda; Kar, Rakhee; Basu, Debdatta

2014-01-01

Gelatinous marrow transformation (GMT) or serous atrophy of bone marrow (BM) is a rare disease characterised by focal marrow hypoplasia, fat atrophy, and accumulation of extracellular mucopolysaccharides abundant in hyaluronic acid. This study reviews 11 cases of GMT from South India. Clinical and haematological parameters, BM aspirate, and biopsies of all patients diagnosed with GMT over a period of 7 years were studied. GMT was diagnosed in BM biopsy based on characteristic morphological appearance and was confirmed by alcian blue positive staining pattern at pH levels of 2.5 and 0.5. Eleven patients were diagnosed with GMT. All were males within the age range of 15 to 50 years. The underlying clinical diagnosis was human immunodeficiency virus positivity in 5 cases, 2 with coexistent disseminated tuberculosis, 1 with cryptococcal meningitis, and 1 with oral candidiasis; disseminated tuberculosis in 1 case; pyrexia of unknown origin in 2 cases; Hodgkin’s lymphoma in 1 case; acute lymphoblastic lymphoma with maintenance chemotherapy in 1 case; and alcoholic pancreatitis in 1 case. BM aspirates showed gelatinous metachromatic seromucinous material in 3 cases. BM biopsies were hypocellular in 7 and normocellular in 4 cases and showed focal GMT in 5 and diffuse GMT in 6 cases. Reactive changes were seen in 4 cases and haemophagocytosis in addition to GMT in 1 case. GMT is a relatively uncommon condition and an indicator of severe illness. It should be differentiated from myelonecrosis, amyloidosis, and marrow oedema. A high index of suspicion is required to diagnose this condition. PMID:25035676

Gelatinous marrow transformation: a series of 11 cases from a tertiary care centre in South India.

PubMed

Das, Sreeya; Mishra, Pritinanda; Kar, Rakhee; Basu, Debdatta

2014-06-01

Gelatinous marrow transformation (GMT) or serous atrophy of bone marrow (BM) is a rare disease characterised by focal marrow hypoplasia, fat atrophy, and accumulation of extracellular mucopolysaccharides abundant in hyaluronic acid. This study reviews 11 cases of GMT from South India. Clinical and haematological parameters, BM aspirate, and biopsies of all patients diagnosed with GMT over a period of 7 years were studied. GMT was diagnosed in BM biopsy based on characteristic morphological appearance and was confirmed by alcian blue positive staining pattern at pH levels of 2.5 and 0.5. Eleven patients were diagnosed with GMT. All were males within the age range of 15 to 50 years. The underlying clinical diagnosis was human immunodeficiency virus positivity in 5 cases, 2 with coexistent disseminated tuberculosis, 1 with cryptococcal meningitis, and 1 with oral candidiasis; disseminated tuberculosis in 1 case; pyrexia of unknown origin in 2 cases; Hodgkin's lymphoma in 1 case; acute lymphoblastic lymphoma with maintenance chemotherapy in 1 case; and alcoholic pancreatitis in 1 case. BM aspirates showed gelatinous metachromatic seromucinous material in 3 cases. BM biopsies were hypocellular in 7 and normocellular in 4 cases and showed focal GMT in 5 and diffuse GMT in 6 cases. Reactive changes were seen in 4 cases and haemophagocytosis in addition to GMT in 1 case. GMT is a relatively uncommon condition and an indicator of severe illness. It should be differentiated from myelonecrosis, amyloidosis, and marrow oedema. A high index of suspicion is required to diagnose this condition.

Accelerating TB notification from the private health sector in Delhi, India.

PubMed

Kundu, Debashish; Chopra, Kamal; Khanna, Ashwani; Babbar, Neeti; Padmini, T J

2016-01-01

In India, almost half of all patients with tuberculosis (TB) seek care in the private sector as the first point of care. The national programme is unable to support such TB patients and facilitate effective treatment, as there is no information on TB and Multi or Extensively Drug Resistant TB (M/XDR-TB) diagnosis and treatment in private sector. To improve this situation, Government of India declared TB a notifiable disease for establishing TB surveillance system, to extend supportive mechanism for TB treatment adherence and standardised practices in the private sector. But TB notification from the private sector is a challenge and still a lot needs to be done to accelerate TB notification. Delhi State TB Control Programme had taken initiatives for improving notification of TB cases from the private sector in 2014. Key steps taken were to constitute a state level TB notification committee to oversee the progress of TB notification efforts in the state and direct 'one to one' sensitisation of private practitioners (PPs) (in single PP's clinic, corporate hospitals and laboratories) by the state notification teams with the help of available tools for sensitising the PP on TB notification - TB Notification Government Order, Guidance Tool for TB Notification and Standards of TB Care in India. As a result of focussed state level interventions, without much external support, there was an accelerated notification of TB cases from the private sector. TB notification cases from the private sector rose from 341 (in 2013) to 4049 (by the end of March 2015). Active state level initiatives have led to increase in TB case notification. Copyright © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Spoligotyping of Mycobacterium tuberculosis isolates from patients with pulmonary tuberculosis in Mumbai, India.

PubMed

Kulkarni, Savita; Sola, Christophe; Filliol, Ingrid; Rastogi, Nalin; Kadival, Gururaj

2005-05-01

Tuberculosis remains a major health problem in India, with 2 million new cases and 421,000 deaths each year. In this paper, we describe the spoligotyping results of 216 Mycobacterium tuberculosis culture isolates from patients with pulmonary tuberculosis in Mumbai, India. As spoligotyping data from India have rarely been described until now, and as there is limited information on the major circulating clades of M. tuberculosis, the data obtained were also compared to an international spoligotype database (SpolDB4) that contained patterns from 22,546 isolates from more than 100 countries. Eighty-four (39%) of the isolates were definitively marked as orphan strains, indicating the paucity of such data from India. The remaining 132 isolates clustered among 59 shared types; among these, 42 shared types were already present in the database, 17 were newly created, and 5 of them were specifically reported from Mumbai. A total of 9 major types in this study clustered 32% of the isolates. At the phylogenetic level, 30% of the isolates belonged to the Central Asian families CAS1 and CAS2, of the major genetic group (MGG) 1, 29% to MGG 2 and 3 families (spacers 33-36 missing) and 17% to the ancestral East African Indian (EAI) family. Finally, nearly 10% of the isolates belonged to the W-Beijing family in a broad sense, also in the MGG 1 group. In conclusion, historic clones of the MGG 1 group of M. tuberculosis are responsible for roughly 60% of all tuberculosis cases in Mumbai. Together with the fact that organisms presumably of European descent (such as the Haarlem family) were only rarely found, our observations suggest that tuberculosis in Mumbai, India is essentially caused by historical clones of tubercle bacilli undergoing active circulation due to uncontrolled demography, high prevalence of the disease, and a paucity of resources.

Social inequalities, tobacco chewing, and cancer mortality in south India: a case-control analysis of 2,580 cancer deaths among non-smoking non-drinkers.

PubMed

Gajalakshmi, Vendhan; Whitlock, Gary; Peto, Richard

2012-03-01

The objective of this work was to describe the relationships between educational level, tobacco chewing, and cancer mortality in south India, among middle-aged adults who never smoked tobacco or drank alcohol, to eliminate confounding by those habits. This case-control study was conducted in two areas of Tamil Nadu state. The cases studied were 2,580 lifelong non-smoking non-drinkers who died at age 35-69 years during 1995-1998, with interviews in 1998-2000 of a spouse, neighbour, or close associate, who retrospectively provided information on the education and chewing/other habits of the deceased. Underlying neoplastic cause of death was determined by verbal autopsy. The controls were 429,306 lifelong non-smoking non-drinkers aged 35-69 from these two study areas, interviewed during 1998-2001. Among the controls, prevalence of current tobacco chewing was much higher in those with less education, irrespective of sex, urban/rural residence, or birth year. Compared with never chewers, ever chewers had fivefold higher mortality from mouth cancer (odds ratio 4.9, 95% confidence interval 3.5-6.8), and 1.5 to twofold higher mortality from cancers of the pharynx/larynx/oesophagus combined, stomach, and cervix. Each of these cancers had a strong, independent, inverse association with educational level. This study supports a substantial body of evidence that tobacco chewing can cause mouth cancer, and adds to evidence that chewing may increase the risk of cancer at other sites. The analysis suggests a possible link with cervical cancer, but this could have been because of residual confounding by social factors. Avoidance of tobacco chewing would avert many cancer deaths in south India, especially for people who have received relatively little formal education.

Influence of socioeconomic aspects on lymphatic filariasis: A case-control study in Andhra Pradesh, India.

PubMed

Mutheneni, Srinivasa Rao; Upadhyayula, Suryanaryana Murty; Kumaraswamy, Sriram; Kadiri, Madhusudhan Rao; Nagalla, Balakrishna

2016-01-01

Lymphatic filariasis (LF) is a major public health problem in India. The objective of the study was to assess the impact of socioeconomic conditions on LF in Chittoor district of Andhra Pradesh, India. A survey was carried out from 2004 to 2007 during which, an epidemiological and socioeconomic data were collected and analysed. The microfilaria (mf) positive samples were taken as cases and matched with control group by sex and age (1:1) for case-control study. Bivariate and multivariate logistic regression was used to identify the potential risk factors for filariasis. Using principal component analysis (PCA), a socioeconomic index was developed and the data/scores were classified into low, medium and high categories. In total 5,133 blood smears were collected, of which 77 samples were found positive for microfilaria (1.52%). Multivariate analysis showed that the risk of filariasis was higher in groups of people with income < ₹1000 per month [OR = 2.752 (95%CI, 0.435-17.429)]; ₹ 1000-3000 per month [3.079 (0.923-0.275)]; people living in tiled house structure [1.641 (0.534-5.048)], with kutcha (uncemented) drainage system [19.427 (2.985- 126.410)], respondents who did not implemented mosquito avoidance measures [1.737 (0.563-5.358)]; and in people who were not aware about prevention and control of filariasis [1.042 (0.368-2.956)]. PCA showed that respondents with low (41.6%) and medium (33.8%) socioeconomic status are more prone to filariasis (p=0.036). The cross sectional study showed that the population with low and medium socioeconomic status are at higher risk of filariasis. The identified socioeconomic risk factors can be used as a guideline for improving the conditions for effective management of filariasis.

Postnatal outcome of congenital anomalies in low resource setting.

PubMed

Kumar, Manisha; Sharma, Sumedha; Bhagat, Manisha; Gupta, Usha; Anand, Rama; Puri, Archana; Singh, Anuradha; Singh, Abha

2013-10-01

This study aimed to determine the postnatal outcome of congenital malformations in a tertiary care hospital of India. This was a prospective study of all women with prenatally detected major congenital malformations. Postnatal follow-up of live born babies was carried out for 1 year. There were 574 cases with major congenital anomalies, 523 of which were fully followed. Only 69 women (13.6%) had the initial scan before 20 weeks of gestation. Craniospinal defects were the most common (42.7%), followed by genitourinary anomalies (28%). There was no live birth in cases such as anencephaly, iniencephaly, bilateral renal agenesis, gastroschisis, and cystic hygroma. Survival at 1 year was less than 25% in spina bifida, bilateral cystic kidneys, complex cardiac disease, and non-immune hydrops fetalis. In cases with mild hydrocephalus or unilateral and mild renal disease, the survival was over 75%. In India, the majority of congenital anomalies present late in gestation. Although fetal outcome is invariably poor for severe defects, existing legislation in the country leaves pregnancy continuation as the only option. © 2013 John Wiley & Sons, Ltd.

Branding in children: a barbaric practice still exists in India

PubMed Central

Patra, Pratap Kumar

2016-01-01

Branding is an inhuman traditional practice most commonly employed to treat various disorders in neonates and children in certain community in India. Though stringent law exists to prevent such harmful practices, cases of branding is not uncommon in current era. PMID:27217887

Reassessing Wind Potential Estimates for India: Economic and Policy Implications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Phadke, Amol; Bharvirkar, Ranjit; Khangura, Jagmeet

2011-09-15

We assess developable on-shore wind potential in India at three different hub-heights and under two sensitivity scenarios – one with no farmland included, the other with all farmland included. Under the “no farmland included” case, the total wind potential in India ranges from 748 GW at 80m hub-height to 976 GW at 120m hub-height. Under the “all farmland included” case, the potential with a minimum capacity factor of 20 percent ranges from 984 GW to 1,549 GW. High quality wind energy sites, at 80m hub-height with a minimum capacity factor of 25 percent, have a potential between 253 GW (nomore » farmland included) and 306 GW (all farmland included). Our estimates are more than 15 times the current official estimate of wind energy potential in India (estimated at 50m hub height) and are about one tenth of the official estimate of the wind energy potential in the US.« less

Promoting wellbeing and improving access to mental health care through community champions in rural India: the Atmiyata intervention approach.

PubMed

Shields-Zeeman, Laura; Pathare, Soumitra; Walters, Bethany Hipple; Kapadia-Kundu, Nandita; Joag, Kaustubh

2017-01-01

There are limited accounts of community-based interventions for reducing distress or providing support for people with common mental disorders (CMDs) in low and middle-income countries. The recently implemented Atmiyata programme is one such community-based mental health intervention focused on promoting wellness and reducing distress through community volunteers in a rural area in the state of Maharashtra, India. This case study describes the content and the process of implementation of Atmiyata and how community volunteers were trained to become Atmiyata champions and mitras ( friends ). The Atmiyata programme trained Atmiyata champions to provide support and basic counselling to community members with common mental health disorders, facilitate access to mental health care and social benefits, improve community awareness of mental health issues, and to promote well-being. Challenges to implementation included logistical challenges (difficult terrain and weather conditions at the implementation site), content-related challenges (securing social welfare benefits for people with CMDs), and partnership challenges (turnover of public health workers involved in referral chain, resistance from public sector mental health specialists). The case study serves as an example for how such a model can be sustained over time at low cost. The next steps of the programme include evaluation of the impact of the Atmiyata intervention through a pre-post study and adapting the intervention for further scale-up in other settings in India.

Spatial Interpolation of Reference Evapotranspiration in India: Comparison of IDW and Kriging Methods

NASA Astrophysics Data System (ADS)

Hodam, Sanayanbi; Sarkar, Sajal; Marak, Areor G. R.; Bandyopadhyay, A.; Bhadra, A.

2017-12-01

In the present study, to understand the spatial distribution characteristics of the ETo over India, spatial interpolation was performed on the means of 32 years (1971-2002) monthly data of 131 India Meteorological Department stations uniformly distributed over the country by two methods, namely, inverse distance weighted (IDW) interpolation and kriging. Kriging was found to be better while developing the monthly surfaces during cross-validation. However, in station-wise validation, IDW performed better than kriging in almost all the cases, hence is recommended for spatial interpolation of ETo and its governing meteorological parameters. This study also checked if direct kriging of FAO-56 Penman-Monteith (PM) (Allen et al. in Crop evapotranspiration—guidelines for computing crop water requirements, Irrigation and drainage paper 56, Food and Agriculture Organization of the United Nations (FAO), Rome, 1998) point ETo produced comparable results against ETo estimated with individually kriged weather parameters (indirect kriging). Indirect kriging performed marginally well compared to direct kriging. Point ETo values were extended to areal ETo values by IDW and FAO-56 PM mean ETo maps for India were developed to obtain sufficiently accurate ETo estimates at unknown locations.

Active detection of tuberculosis and paragonimiasis in the remote areas in North-Eastern India using cough as a simple indicator.

PubMed

Rekha Devi, Kangjam; Narain, Kanwar; Mahanta, Jagadish; Deori, Rumi; Lego, Kabang; Goswami, Dibyajyoti; Kumar Rajguru, Sanjib; Agatsuma, Takeshi

2013-04-01

One of the essential steps in targeting tuberculosis (TB) intervention is early diagnosis and treatment of patients by reducing the reservoir of infection in the community. In the North-Eastern (NE) region of India pulmonary TB and paragonimiasis are overlapping public health issues. We performed a cross-sectional study in 63 remote villages from the two states Arunachal Pradesh (AP) and Assam to determine the prevalence of undiagnosed TB and paragonimiasis cases using cough as a simple indicator. In AP, 2961 individuals aged five years and above were examined and 1108 (37·4%) were found to have cough for one week or more. Of the 417 individuals who provided sputum, 11 (2·64%) were smear positive for acid-fast bacilli (AFB). All these cases were yet undiagnosed, thus the prevalence of new smear positive TB in AP was 0·37%. In Assam on the other hand 331 (23·5%) subjects out of 1410 individuals who were examined had a cough for one week or more and of the 112 individuals who provided sputum, 13 (11·6%) were smear positive for AFB. The prevalence of new smear positive TB cases was 0·78% in Assam. Sero-positivity of paragonimiasis in coughers of AP was 7·6% (n = 1091), which was significantly higher (p < 0·01) as compared to that in Assam (1·2%, n = 321). The findings of the present study suggest that TB remains a major public health concern in the NE region of India especially in the remote places and there is need to strengthen early case detection of TB.

Active detection of tuberculosis and paragonimiasis in the remote areas in North-Eastern India using cough as a simple indicator

PubMed Central

Rekha Devi, Kangjam; Narain, Kanwar; Mahanta, Jagadish; Deori, Rumi; Lego, Kabang; Goswami, Dibyajyoti; Kumar Rajguru, Sanjib; Agatsuma, Takeshi

2013-01-01

One of the essential steps in targeting tuberculosis (TB) intervention is early diagnosis and treatment of patients by reducing the reservoir of infection in the community. In the North-Eastern (NE) region of India pulmonary TB and paragonimiasis are overlapping public health issues. We performed a cross-sectional study in 63 remote villages from the two states Arunachal Pradesh (AP) and Assam to determine the prevalence of undiagnosed TB and paragonimiasis cases using cough as a simple indicator. In AP, 2961 individuals aged five years and above were examined and 1108 (37.4%) were found to have cough for one week or more. Of the 417 individuals who provided sputum, 11 (2.64%) were smear positive for acid-fast bacilli (AFB). All these cases were yet undiagnosed, thus the prevalence of new smear positive TB in AP was 0.37%. In Assam on the other hand 331 (23.5%) subjects out of 1410 individuals who were examined had a cough for one week or more and of the 112 individuals who provided sputum, 13 (11.6%) were smear positive for AFB. The prevalence of new smear positive TB cases was 0.78% in Assam. Sero-positivity of paragonimiasis in coughers of AP was 7.6% (n  =  1091), which was significantly higher (p < 0.01) as compared to that in Assam (1.2%, n  =  321). The findings of the present study suggest that TB remains a major public health concern in the NE region of India especially in the remote places and there is need to strengthen early case detection of TB. PMID:23683370

Cultural considerations in the diagnosis and treatment of schizophrenia: A case example from India.

PubMed

Dhanasekaran, Saranya; Loganathan, Santosh; Dahale, Ajit; Varghese, Mathew

2017-06-01

Culture plays an important role in the presentation, help seeking, treatment and outcomes of psychiatric illnesses like schizophrenia. We report a case of paranoid schizophrenia in a 35-year-old lady, from South India, whose clinical presentation was influenced by various sociocultural factors. These cultural constructs were taken into consideration to formulate an acceptable and effective management plan. A detailed case description using a cultural formulation to highlight the etic and emic perspectives and challenges in treatment and management are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

Does Measles Vaccination Reduce the Risk of Acute Respiratory Infection (ARI) and Diarrhea in Children: A Multi-Country Study?

PubMed

Bawankule, Rahul; Singh, Abhishek; Kumar, Kaushalendra; Shetye, Sadanand

2017-01-01

Pneumonia and diarrhea occur either as complications or secondary infections in measles affected children. So, the integrated Global Action Plan for Pneumonia and Diarrhea (GAPPD) by WHO and UNICEF includes measles vaccination as preventive measure in children. The objective of the study is to examine the effect of measles vaccination on Acute Respiratory Infection (ARI) and diarrhea in children in the Democratic Republic of Congo, Ethiopia, India, Nigeria, and Pakistan. We analyzed data from the most recent rounds of Demographic and Health Surveys (DHS) in the selected countries. We included children age 12-59 months in the analysis. We used multivariable binary logistic regression to examine the effect of measles vaccination on ARI and diarrhea in children. We also estimated Vaccination Effectiveness (VE). More than 60 percent of the children age 12-59 months were given measles vaccine before the survey in the Democratic Republic of Congo, Ethiopia, India and Pakistan. Children who were given the measles vaccine were less likely to suffer from ARI than unvaccinated children in India and Pakistan. Children who were given the measles vaccine had a lower risk of diarrhea than those who did not receive it in all the selected countries except Ethiopia. Measles vaccination was associated with reduction in ARI cases by 15-30 percent in India and Pakistan, and diarrhea cases by 12-22 percent in the Democratic Republic of Congo, India, Nigeria and Pakistan. The receipt of the measles vaccine was associated with decrease in ARI and diarrhea in children. The immunization program must ensure that each child gets the recommended doses of measles vaccine at the appropriate age. The measles vaccination should be given more attention as a preventive intervention under the Global Action Plan for Pneumonia and Diarrhea (GAPPD) in all low and middle-income countries.

A demographic dividend of the FP2020 Initiative and the SDG reproductive health target: Case studies of India and Nigeria.

PubMed

Li, Qingfeng; Rimon, Jose G

2018-02-22

Background: The demographic dividend, defined as the economic growth potential resulting from favorable shifts in population age structure following rapid fertility decline, has been widely employed to advocate improving access to family planning. The current framework focuses on the long-term potential, while the short-term benefits may also help persuade policy makers to invest in family planning. Methods: We estimate the short- and medium-term economic benefits from two major family planning goals: the Family Planning 2020 (FP2020)'s goal of adding 120 million modern contraceptive users by 2020; Sustainable Development Goals (SDG) 3.7 of ensuring universal access to family planning by 2030. We apply the cohort component method to World Population Prospects and National Transfer Accounts data. India and Nigeria, respectively the most populous Asian and African country under the FP2020 initiative, are used as case studies. Results: Meeting the FP2020 target implies that on average, the number of children that need to be supported by every 100 working-age people would decrease by 8 persons in India and 11 persons in Nigeria in 2020; the associated reduction remains at 8 persons in India, but increases to 14 persons in Nigeria by 2030 under the SDG 3.7. In India meeting the FP2020 target would yield a saving of US$18.2 billion (PPP) in consumption expenditures for children and youth in the year 2020 alone, and that increased to US$89.7 billion by 2030. In Nigeria the consumption saved would be US$2.5 billion in 2020 and $12.9 billion by 2030. Conclusions: The tremendous economic benefits from meeting the FP2020 and SDG family planning targets demonstrate the cost-effectiveness of investment in promoting access to contraceptive methods. The gap already apparent between the observed and targeted trajectories indicates tremendous missing opportunities. Accelerated progress is needed to achieve the FP2020 and SDG goals and so reap the demographic dividend.

Should sputum-negative presumptive TB patients be actively followed to identify missing cases in India?

PubMed

Waikar, S; Pathak, A; Ghule, V; Kapoor, A; Sagili, K; Babu, E R; Chadha, S

2017-12-21

Setting: Sputum smear microscopy, the primary diagnostic tool used for diagnosis of tuberculosis (TB) in India's Revised National TB Control Programme (RNTCP), has low sensitivity, resulting in a significant number of TB cases reported as sputum-negative. As the revised guidelines pose challenges in implementation, sputum-negative presumptive TB (SNPT) patients are subjected to 2 weeks of antibiotics, followed by chest X-ray (CXR), resulting in significant loss to care among these cases. Objective: To determine whether reducing delays in CXR would yield additional TB cases and reduce initial loss to follow-up for diagnosis among SNPT cases. Methods: In an ongoing intervention in five districts of Maharashtra, SNPT patients were offered upfront CXR. Results: Of 119 male and 116 female SNPT patients with a mean age of 45 years who were tested by CXR, 32 (14%) were reported with CXR suggestive of TB. Administering upfront CXR in SNPT patients yielded twice as many additional cases, doubling the proportion of cases detected among all those tested as against administering CXR 2 weeks after smear examination. Conclusion: Our interventional study showed that the yield of TB cases was significantly greater when upfront CXR examination was undertaken without waiting for a 2-week antibiotic trial.

Clinical profile, predisposing factors, and associated co-morbidities of children with cerebral palsy in South India

PubMed Central

Gowda, Vykuntaraju K.; Kumar, Anil; Shivappa, Sanjay K.; Srikanteswara, Praveen Kumar; Shivananda; Mahadeviah, M. S.; Govindraj, M.; Ramaswamy, Premalatha

2015-01-01

Introduction: Cerebral palsy (CP) is the most common physical disorder of children. Causes like jaundice and birth injury though are decreasing; complications resulting from the survival of low birth weight babies are replacing some of the older etiologies. Hence, this study was planned. Objectives: The objective was to study the clinical patterns, predisposing factors, and co-morbidities in children with CP. Materials and Methods: The present study is a hospital based prospective study conducted from January 2012 to January 2013 in children presenting to neurodevelopmental clinic at a tertiary care teaching hospital in India. Hundred cases with clinical features suggestive of CP were included in the study. Cases were evaluated by history, clinical examination, and necessary investigations. Results: Results of the study showed 81% of spastic, 12% of hypotonic, 5% of dystonic, and 2% of mixed CP cases. The mean age of presentation was 2 year, 2 month, and male to female ratio of 1:2. Pregnancy-induced hypertension (PIH) was the most common antenatal complication observed in 6%. Four percent had neonatal sepsis and 19% were born premature. Associated co-morbidities were mental retardation (55%), seizure disorder (46%), visual problems (26%), hearing problems (19%), and failure to thrive (47%). Discussion: Sex distribution observed in our study was male to female ratio of 1.2, which was comparable with a multicenter study in Europe. PIH was observed in 6% of cases, which was comparable with prior studies. Birth asphyxia was observed in 43% of cases. Eighty-one percent of the cases constituted a spastic variety of CP which was comparable to other studies. Conclusion: Perinatal asphyxia was the important etiological factor. We found preventable intranatal causes (60%) and antenatal causes (20%) forming a significant proportion. Co-morbidities were significantly observed in our study. PMID:26167210

Global elimination of leprosy by 2020: are we on track?

PubMed

Blok, David J; De Vlas, Sake J; Richardus, Jan Hendrik

2015-10-22

Every year more than 200,000 new leprosy cases are registered globally. This number has been fairly stable over the past 8 years. WHO has set a target to interrupt the transmission of leprosy globally by 2020. The aim of this study is to investigate whether this target, interpreted as global elimination, is feasible given the current control strategy. We focus on the three most important endemic countries, India, Brazil and Indonesia, which together account for more than 80 % of all newly registered leprosy cases. We used the existing individual-based model SIMCOLEP to predict future trends of leprosy incidence given the current control strategy in each country. SIMCOLEP simulates the spread of M. leprae in a population that is structured in households. Current control consists of passive and active case detection, and multidrug therapy (MDT). Predictions of leprosy incidence were made for each country as well as for one high-endemic region within each country: Chhattisgarh (India), Pará State (Brazil) and Madura (Indonesia). Data for model quantification came from: National Leprosy Elimination Program (India), SINAN database (Brazil), and Netherlands Leprosy Relief (Indonesia). Our projections of future leprosy incidence all show a downward trend. In 2020, the country-level leprosy incidence has decreased to 6.2, 6.1 and 3.3 per 100,000 in India, Brazil and Indonesia, respectively, meeting the elimination target of less than 10 per 100,000. However, elimination may not be achieved in time for the high-endemic regions. The leprosy incidence in 2020 is predicted to be 16.2, 21.1 and 19.3 per 100,000 in Chhattisgarh, Pará and Madura, respectively, and the target may only be achieved in another 5 to 10 years. Our predictions show that although country-level elimination is reached by 2020, leprosy is likely to remain a problem in the high-endemic regions (i.e. states, districts and provinces with multimillion populations), which account for most of the cases in a country.

New Strategies for Improving Rural Family Life.

ERIC Educational Resources Information Center

Coombs, Philip H.

Presented in capsule form for the convenience of busy policy makers, planners, and program managers, this booklet summarizes major findings of a three-year study on practical aspects of rural development, with particular emphasis on ways of alleviating extreme poverty among disadvantaged rural families. Using case studies from Bangladesh, India,…

Maternal-related deaths and impoverishment among adolescent girls in India and Niger: findings from a modelling study.

PubMed

Verguet, Stéphane; Nandi, Arindam; Filippi, Véronique; Bundy, Donald A P

2016-09-26

High levels of maternal mortality and large associated inequalities exist in low-income and middle-income countries. Adolescent pregnancies remain common, and pregnant adolescent women face elevated risks of maternal mortality and poverty. We examined the distribution across socioeconomic groups of maternal deaths and impoverishment among adolescent girls (15-19 years old) in Niger, which has the highest total fertility rate globally, and India, which has the largest number of maternal deaths. In Niger and India, among adolescent girls, we estimated the distribution per income quintile of: the number of maternal deaths; and the impoverishment, measured by calculating the number of cases of catastrophic health expenditure incurred, caused by complicated pregnancies. We also examined the potential impact on maternal deaths and poverty of increasing adolescent girls' level of education by 1 year. We used epidemiological and cost inputs sourced from surveys and the literature. The number of maternal deaths would be larger among the poorer adolescents than among the richer adolescents in Niger and India. Impoverishment would largely incur among the richer adolescents in Niger and among the poorer adolescents in India. Increasing educational attainment of adolescent girls might avert both a large number of maternal deaths and a significant number of cases of catastrophic health expenditure in the 2 countries. Adolescent pregnancies can lead to large equity gaps and substantial impoverishment in low-income and middle-income countries. Increasing female education can reduce such inequalities and provide financial risk protection and poverty alleviation to adolescent girls. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Analysis of bacterial and fungal communities in Marcha and Thiat, traditionally prepared amylolytic starters of India.

PubMed

Sha, Shankar Prasad; Jani, Kunal; Sharma, Avinash; Anupma, Anu; Pradhan, Pooja; Shouche, Yogesh; Tamang, Jyoti Prakash

2017-09-08

Marcha and thiat are traditionally prepared amylolytic starters use for production of various ethnic alcoholic beverages in Sikkim and Meghalaya states in India. In the present study we have tried to investigate the bacterial and fungal community composition of marcha and thiat by using high throughput sequencing. Characterization of bacterial community depicts phylum Proteobacteria is the most dominant in both marcha (91.4%) and thiat (53.8%), followed by Firmicutes, and Actinobacteria. Estimates of fungal community composition showed Ascomycota as the dominant phylum. Presence of Zygomycota in marcha distinguishes it from the thiat. The results of NGS analysis revealed dominance of yeasts in marcha whereas molds out numbers in case of thiat. This is the first report on microbial communities of traditionally prepared amylolytic starters of India using high throughput sequencing.

Pathology of fungal infections of the central nervous system: 17 years' experience from Southern India.

PubMed

Sundaram, C; Umabala, P; Laxmi, V; Purohit, A K; Prasad, V S S V; Panigrahi, M; Sahu, B P; Sarathi, M V; Kaul, S; Borghain, R; Meena, A K; Jayalakshmi, S S; Suvarna, A; Mohandas, S; Murthy, J M K

2006-10-01

To describe the pathology of central nervous system (CNS) fungal infections with particular reference to India. This was a retrospective study from 1988 to 2004 constituting 130 cases. The diagnosis was based on morphology of biopsy/autopsy material. These included aspergillosis (n=73), zygomycosis (n=40), cryptococcosis (n=2), rhodotorulosis (n=1), candidiasis (n=5), maduramycosis (n=1), pheohyphomycosis (n=3) and mixed infections (n=5). Predisposing risk factors were present in 49 (38%) patients only. The majority of the patients were immunocompetent. The commonest risk factor was diabetes mellitus, the commonest route of infection was from a contiguous site and the commonest pathology was granuloma. Culture positivity was seen in only 31%. Environmental factors in tropical countries such as India play a significant role in the pathogenesis of CNS fungal infections.

Problems of Adolescents and Youths: Symposium IV C.

ERIC Educational Resources Information Center

Nagaraja, Jaya; Suppiah, Chandraseagran

This symposium contains reports on: (1) a study of drug abuse among adolescents in India, by Jaya Nagaraja; and (2) a case study of factors contributing to drug addiction among Malaysian youth, by Chandraseagran Suppiah. Based on a sample of 1,000 adolescents attending metropolitan city colleges, findings of the Indian study concern psychological…

Problem Oriented Literacy Materials Preparation: A Case Study

ERIC Educational Resources Information Center

Tripathi, Virendra

1975-01-01

One of the recent innovations of significance in developing nations is the concept of linking literacy education to problems related to socio-economic development. The article describes the Problem Oriented Materials Preparation Project of Literacy House, Lucknow, India. (Author/BP)

Xpert(®) MTB/RIF for improved case detection of extra-pulmonary TB in a tertiary care setting in urban India.

PubMed

Nataraj, G; Kanade, S; Mehta, P

2016-07-01

Department of microbiology at a tertiary care hospital, Mumbai, India. To determine 1) the sensitivity and specificity of the Xpert(®) MTB/RIF assay in comparison with microscopy and culture in extra-pulmonary tuberculosis (EPTB), and 2) the number of additional cases of EPTB and rifampicin (RMP) resistance detected using this assay. The study was conducted from July 2013 to April 2015. All consecutive patients with clinically suspected EPTB referred for microscopic examination to the Department of Microbiology that were sufficient in specimen volume were included in the study. Of the 728 specimens included in the study, respectively 5.5%, 23.5% and 20.9% were positive on smear, culture and Xpert. Compared to culture, Xpert had a sensitivity of 84.2% (95%CI 81.4-86.6) and specificity of 98.2% (95%CI 90-104). All specimens with high and medium load on assay were positive on culture; 28 (18.4%) specimens were RMP-resistant and 124 (81.6%) were Xpert-susceptible. No additional RMP-resistant cases were detected using Xpert as compared to phenotypic drug susceptibility testing. The ability of the Xpert assay to rapidly detect a significantly greater number of bacteriologically confirmed EPTB cases, including RMP-resistant cases, makes it an important diagnostic tool in a TB-endemic country.

Mental health status of unmarried youth living in single parent families: a case study from India.

PubMed

Sinha, Atreyee; Ram, Faujdar

2018-02-16

In South Asian countries like India, family system lays a strong foundation in societies and therefore, the context and consequences of single parent family structures are markedly different from that of the West. In these societies single parenthood is mainly an outcome of untimely death of any one of the parents. This study tried to examine the influence of parents' survival status on the mental health of youth in India. "Youth in India: situation and Needs (2006-2007)" survey data was used in the present study. We compared two groups of unmarried young population aged 15-24 y (n = 28 637): one having both parents alive and another having only one parent alive. Bivariate and multivariate techniques were applied to analyze the data. Results revealed that around 11% of the unmarried youth belonged to single parent families. Findings underscored a significant association between parent's survival and mental health of youth; respondents from single parent families were more likely to report metal health problems Moreover, effects of parents' survival were significant on females' mental health rather than males'. Policies must focus on reducing stress of young people growing up in single parent families through enhanced educational and employment opportunities.

Detection of Human Papilloma Virus and Risk Factors among Patients with Head and Neck Squamous Cell Carcinoma Attending a Tertiary Referral Centre in South India

PubMed

Bandhary, Satheesh K; Shetty, Veena; Saldanha, Marina; Gatti, Priya; Devegowda, Devananda; R, Pushkal S; Shetty, Avinash K

2018-05-26

Background: Head and Neck Squamous Cell Carcinomas (HNSCC) is the sixth most common cancer globally. In India, on an average 25-30% of all cancer cases affect the head and neck. The etiological factors associated with HNSCC are tobacco, alcohol and environmental carcinogens. However there are few cases, where there are no obvious risk factors involved. In western counties, there are many reports of human papilloma virus (HPV) association with HNSCC. Hence, we conducted a study to determine the role of HPV infection and risk factors among patients with HNSCC. Materials and Methods: A prospective, cross-sectional study was conducted in a tertiary referral centre from January 2014 to March 2016. 88 patients were enrolled in the study. Socio- demographic, behavioural data, site and subsite involvement, histopathology, staging and treatment were documented. Polymerase chain reaction (PCR) was performed to detect the presence of HPV DNA using consensus primers MY 09/11 and GP5+/GP6+ and further the samples were subjected to PCR for detecting HPV type 16 and 18. Results: The study included 88 participants with HNSCC. 57 had oral and oropharyngeal squamous cell carcinoma, 11 with laryngeal malignancy and 20 involving hypopharynx. Among the participants buccal mucosa (n=22) was the most common subsite involved, majority (50%) had moderately differentiated squamous cell carcinoma and 53.4% presented in stage IV. 2 (2.6%) cases were positive for HPV consensus and both were positive for HPV 16, one case each in larynx and hypopharynx. There was statistical significance in the association between betel nut chewing, cigarette smoking and alcohol intake as risk factors in the carcinogenesis of HNSCC. Conclusion: In our setting in South India, HPV does not play a major role in the carcinogenesis of HNSCC but betel nut chewing, tobacco exposure and alcohol consumption remain major risk factors for HNSCC. Creative Commons Attribution License

Developing a framework to review near-miss maternal morbidity in India: a structured review and key stakeholder analysis.

PubMed

Bhattacharyya, Sanghita; Srivastava, Aradhana; Knight, Marian

2014-11-13

In India there is a thrust towards promoting institutional delivery, resulting in problems of overcrowding and compromise to quality of care. Review of near-miss obstetric events has been suggested to be useful to investigate health system functioning, complementing maternal death reviews. The aim of this project was to identify the key elements required for a near-miss review programme for India. A structured review was conducted to identify methods used in assessing near-miss cases. The findings of the structured review were used to develop a suggested framework for conducting near-miss reviews in India. A pool of experts in near-miss review methods in low and middle income countries (LMICs) was identified for vetting the framework developed. Opinions were sought about the feasibility of implementing near-miss reviews in India, the processes to be followed, factors that made implementation successful and the associated challenges. A draft of the framework was revised based on the experts' opinions. Five broad methods of near-miss case review/audit were identified: Facility-based near-miss case review, confidential enquiries, criterion-based clinical audit, structured case review (South African Model) and home-based interviews. The opinion of the 11 stakeholders highlighted that the methods that a facility adopts should depend on the type and number of cases the facility handles, availability and maintenance of a good documentation system, and local leadership and commitment of staff. A proposed framework for conducting near-miss reviews was developed that included a combination of criterion-based clinical audit and near-miss review methods. The approach allowed for development of a framework for researchers and planners seeking to improve quality of maternal care not only at the facility level but also beyond, encompassing community health workers and referral. Further work is needed to evaluate the implementation of this framework to determine its efficacy in improving the quality of care and hence maternal and perinatal morbidity and mortality.

Unravelling the Molecular Epidemiology and Genetic Diversity among Burkholderia pseudomallei Isolates from South India Using Multi-Locus Sequence Typing.

PubMed

Tellapragada, Chaitanya; Kamthan, Aayushi; Shaw, Tushar; Ke, Vandana; Kumar, Subodh; Bhat, Vinod; Mukhopadhyay, Chiranjay

2016-01-01

There is a slow but steady rise in the case detection rates of melioidosis from various parts of the Indian sub-continent in the past two decades. However, the epidemiology of the disease in India and the surrounding South Asian countries remains far from well elucidated. Multi-locus sequence typing (MLST) is a useful epidemiological tool to study the genetic relatedness of bacterial isolates both with-in and across the countries. With this background, we studied the molecular epidemiology of 32 Burkholderia pseudomallei isolates (31 clinical and 1 soil isolate) obtained during 2006-2015 from various parts of south India using multi-locus sequencing typing and analysis. Of the 32 isolates included in the analysis, 30 (93.7%) had novel allelic profiles that were not reported previously. Sequence type (ST) 1368 (n = 15, 46.8%) with allelic profile (1, 4, 6, 4, 1, 1, 3) was the most common genotype observed. We did not observe a genotypic association of STs with geographical location, type of infection and year of isolation in the present study. Measure of genetic differentiation (FST) between Indian and the rest of world isolates was 0.14413. Occurrence of the same ST across three adjacent states of south India suggest the dispersion of B.pseudomallei across the south western coastal part of India with limited geographical clustering. However, majority of the STs reported from the present study remained as "outliers" on the eBURST "Population snapshot", suggesting the genetic diversity of Indian isolates from the Australasian and Southeast Asian isolates.

Rheumatic heart disease: progress and challenges in India.

PubMed

Shah, Bela; Sharma, Meenakshi; Kumar, Rajesh; Brahmadathan, K N; Abraham, Vinod Joseph; Tandon, Rajan

2013-03-01

Rheumatic heart disease, a neglected disease, continues to be a burden in India and other developing countries. It is a result of an autoimmune sequalae in response to group A beta hemolytic streptococcus (GAS) infection of the pharynx. Acute rheumatic fever (RF), a multisystem inflammatory disease, is followed by rheumatic heart disease (RHD) and has manifestations of joints, skin and central nervous system involvement. A review of epidemiological studies indicates unchanged GAS pharyngitis and carrier rates in India. The apparent decline in RHD rates in India as indicated by the epidemiological studies has to be taken with caution as methodological differences exist among studies. Use of echocardiography increases case detection rates of RHD in population surveys. However, the significance of echo based diagnosis of carditis needs further evaluation to establish the significance. Research in this area through prospective follow up studies will have to be undertaken by the developing countries as the interest of developed countries in the disease has waned due the declined burden in their populations. Prevention of RHD is possible through treatment of GAS pharyngitis (primary prophylaxis) and continued antibiotic treatment for number of years in patients with history of RF to prevent recurrences (secondary prophylaxis). The cost effectiveness and practicality of secondary prophylaxis is well documented. The challenge to any secondary prophylaxis program for prevention of RF in India will be the availability of benzathine penicillin G and dissipation of fears of allergic reactions to penicillin among practitioners, general public and policy makers. The authors review here the progress and challenges in epidemiology, diagnosis and primary and secondary prevention of RF and RHD.

Bilateral periorbital necrotizing fasciitis following exposure to Holi colors: a case report.

PubMed

Chauhan, Deepender; Arora, Ritu; Das, Sima; Shroff, Daraius; Narula, Ritesh

2007-01-01

Holi festival is celebrated in India traditionally by applying colors on one another. Various ocular adverse effects of these colors have been reported including conjunctivitis and corneal abrasion. We report a case of bilateral periorbital necrotizing fasciitis, following exposure to Holi colors. General physicians might encounter more such cases after exposure to Holi colors. In India, these colors are prepared on a small scale and lack any quality checks. Use of such toxic colors should be discouraged, and all doctors should caution people against using synthetic dyes. This case report highlights the need to put manufacturing of Holi colors under guidelines of the Food and Drug Cosmetic Act and the Bureau of Indian Standards.

Clinicohaematological profile of aplastic anaemia in a rural medical college of Northern West Bengal.

PubMed

Chakrabarti, Sudipta; Goswami, Bidyut Krishna; Paul, Prabir Chandra; Sarkar, Supriya; Mondal, Srikrishna; Das, Shikha

2013-10-01

There is a scarcity of clinical data in the field of aplastic anaemia from rural India. Present study was conducted in North Bengal Medical College to find out the clinicohaematological profile and the possible aetiological factors in patients with aplastic anaemia. The study population (n = 83) included 21 children with male to female ratio 4.93:1. Weakness was present in all cases and pallor was present in 74.70% cases. Fever, bleeding episodes and localised infection were found in 55.42%, 48.19% and 27.71% cases respectively. There was no difference in clinical manifestations between children and adult except occurrence of fever (p = 0.0365). We identified possible aetiological factors in 32.53% cases as relevant drug intake in 10.84%, exposure to chemicals in 13.25% and hepatitis in 8.43% cases. We found low mean haemoglobin (3.81 +/- 1.71 g/dl), leucocyte and platelet (3.05 +/- 1.3 and 37.30 +/- 35 x 10(3)/cmm), neutrophil (30.28 +/- 21.76%) and high lymphocyte (67.27 +/- 22.50%) in peripheral blood. At the time of presentation, aplastic anaemia was moderate in 59.04% cases, severe in 48.19% cases and mild in 4.82% cases. We estimated the prevalence of aplastic anaemia in 4 districts of West Bengal including tea garden areas was 2.98/million populations per year. It was concluded that aplastic anaemia is a major non-malignant haematological disease in this part of India, and an increasing use of chemicals in agricultural and tea garden areas might be the responsible factor. Larger population based study is suggested.

Risk factors for treatment default among re-treatment tuberculosis patients in India, 2006.

PubMed

Jha, Ugra Mohan; Satyanarayana, Srinath; Dewan, Puneet K; Chadha, Sarabjit; Wares, Fraser; Sahu, Suvanand; Gupta, Devesh; Chauhan, L S

2010-01-25

Under India's Revised National Tuberculosis Control Programme (RNTCP), >15% of previously-treated patients in the reported 2006 patient cohort defaulted from anti-tuberculosis treatment. To assess the timing, characteristics, and risk factors for default amongst re-treatment TB patients. For this case-control study, in 90 randomly-selected programme units treatment records were abstracted from all 2006 defaulters from the RNTCP re-treatment regimen (cases), with one consecutively-selected non-defaulter per case. Patients who interrupted anti-tuberculosis treatment for >2 months were classified as defaulters. 1,141 defaulters and 1,189 non-defaulters were included. The median duration of treatment prior to default was 81 days (25%-75% interquartile range 44-117 days) and documented retrieval efforts after treatment interruption were inadequate. Defaulters were more likely to have been male (adjusted odds ratio [aOR] 1.4, 95% confidence interval [CI] 1.2-1.7), have previously defaulted anti-tuberculosis treatment (aOR 1.3 95%CI 1.1-1.6], have previous treatment from non-RNTCP providers (AOR 1.3, 95%CI 1.0-1.6], or have public health facility-based treatment observation (aOR 1.3, 95%CI 1.1-1.6). Amongst the large number of re-treatment patients in India, default occurs early and often. Improved pre-treatment counseling and community-based treatment provision may reduce default rates. Efforts to retrieve treatment interrupters prior to default require strengthening.

Human trafficking for organ removal in India: a victim-centered, evidence-based report.

PubMed

Budiani-Saberi, Debra A; Raja, Kallakurichi Rajendiran; Findley, Katie C; Kerketta, Ponsian; Anand, Vijay

2014-02-27

Enhancements in the national transplant law to prohibit commercial transplants in India have curbed the trade. Yet, the human rights abuse of human trafficking for organ removal (HTOR) continues in various transplant centers throughout India. Beginning in September 2010 until May 2012, in-depth interviews were conducted with 103 victims of HTOR in India in which victims described their experiences of a commercial kidney removal in compelling detail. Victims were located in Tamil Nadu, and reference is made to the broader study that included 50 additional victims in small towns and villages in West Bengal and Karnataka. Fourteen cases (14%) in Tamil Nadu and an additional 20 cases (40%) from West Bengal and Karnataka occurred between 2009 to May 2012. The cases in Tamil Nadu ranged in age from 19 to 55 years, with an average age of 33 years in Erode and 36 years in Chennai. Fifty-seven percent of the victims in Erode are female, and 87% of the victims in Chennai are female. Twelve percent of the individuals were widowed or abandoned, 79% were married, and 91% were parents with an average of two kids. Of those interviewed, 28% had no formal education, 19% had some primary schooling, 22% had some secondary schooling, and no individuals reported schooling above high school. All victims interviewed lived in abject poverty with monthly income levels well below the national average. The majority of victims reported long lasting health, economic, social, and psychological consequences. No matter the reason expressed for an organ sale, all victims reported that they would not have agreed to the organ removal if their economic circumstances were not so dire. One hundred percent of the victims interviewed expressed that they need assistance to cope with these consequences. Human trafficking for an organ removal continues in private transplant centers throughout India, service to foreign patients is ongoing, and victims' consequences are long lasting. A rights-based response to HTOR that invokes a universal commitment to prevent, protect, and suppress its continued practice is recommended. The United Nations Trafficking Protocol is the key international instrument to address trafficking of persons, including for organ removal. India has signed the UN Trafficking Protocol and should ratify it to better address this form of human trafficking.

Self-inflicted burns fatalities in Manipal, India.

PubMed

Mohanty, Manoj Kumar; Arun, M; Monteiro, Francis N P; Palimar, Vikram

2005-01-01

Death due to burns is an important public health problem. Suicide by burning is uncommon in the Western world compared with Asian countries. This study presents retrospective research carried out in the tertiary care teaching hospital of Kasturba Medical College, Manipal, Southern India, between January 1993 to December 2003 (11 years). Out of a total of 343 burns deaths during the above-mentioned period, 39 were victims of suicide. The majority of deaths (46.1%) occurred in the 21-30 years age group, with a preponderance of the female sex (79.5%). Most of the victims belonged to the Hindu religion and the incident occurred mostly during the daytime. In the overwhelming majority of cases, the incident occurred at home (97.4%). In all cases kerosene was the accelerant and flame was the causative agent. In more than fifty per cent of cases, the total body surface area (TBSA) involved was more than 80%. Dowry demands and harassment were the reasons for committng suicide in 12 cases. More stringent laws and empowering female independence, both mentally and economically, will reduce suicidal burns in young women.

Emergence of Noroviruses homologous to strains reported from Djibouti (horn of Africa), Brazil, Italy, Japan and USA among children in Kolkata, India.

PubMed

Nataraju, S M; Ganesh, B; Das, S; Chowdhury, S; Nayak, M K; Ghosh, M; Chatterjee, M K; Sarkar, U; Mitra, U; Bhattacharya, M K; Arora, R; Kobayashi, N; Krishnan, T

2010-09-01

A total of 625 faecal specimens of diarrheic cases (n-313) and non diarrheic controls (n-312), were screened by RT-PCR to detect Noroviruses in children aged below 5 years in Kolkata, India. Out of the 313 fecal specimens (cases) screened using CDC primer set, 10 (3.19%) showed amplification in reverse transcription-polymerase chain reaction (RT-PCR) for Norovirus. These included 5 of 260 (1.92%) from hospitalized and 5 of 53 (9.43%) from out patients departament (OPD) cases. Nine (90%) of Norovirus positive cases belonged to genogroup GII and one specimen (10%) was positive for genogroup GI. Among the 312 non diarrheic controls 2 (0.63%) were positive for Norovirus GII. Partial RNA dependent RNA polymerase gene (RdRp) sequences corresponding to the six Norovirus GII positive samples showed homology to the sequences of Djibouti (horn of Africa), Brazil, Italy, Japan and US norovirus strains. This study shows the detection of newly emerging Norovirus strains among diarrheic and non diarrheic children in Kolkata.

Linezolid resistant Staphylococcus haemolyticus: first case report from India.

PubMed

Gupta, Varsha; Garg, Shivani; Jain, Ruby; Garg, Sudhir; Chander, Jagdish

2012-10-01

Linezolid is being increasingly used in the treatment of infections with gram-positive organisms especially methicillin resistant Staphylococcal isolates. Though resistance to this antimicrobial is emerging but it is extremely rare. Here we document first case of linezolid resistant Staphylococcus haemolyticus (S.haemolyticus) from India. This organism was isolated from pus oozing from a postsurgical site in 61 year old male hailing from an adjoining state of Haryana. Copyright © 2012 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

A Case Series and Review of Bacillus Cereus Endocarditis from India.

PubMed

Gopinathan, Anusha; Kumar, Anil; Sen, Amitabh C; Sudha, Srisruthy; Varma, Praveen; Gs, Sunil; Eapen, Malini; Dinesh, Kavitha R

2018-01-01

Bacillus cereus is a gram positive bacilli found commonly in the soil and environment. It is a bacteria rarely associated with endocarditis. Intravenous drug abuse, presence of valvular defects, pacemakers, immunodeficiency are some of the known risk factors for B.cereus endocarditis. We present here a case series of two patients with B.cereus endocarditis along with a review of the literature. This is the first report of B.cereus endocarditis from India to the best of our knowledge.

The role of non-governmental organizations in residential solid waste management: a case study of Puducherry, a coastal city of India.

PubMed

Rajamanikam, Ramamoorthy; Poyyamoli, Gopalsamy; Kumar, Sunil; R, Lekshmi

2014-09-01

Poorly planned and uncontrolled urbanization in India has caused a variety of negative, often irreversible, environmental impacts. The impacts appear to be unavoidable and not easily mitigable due to the mounting public health problems caused by non-segregation of solid wastes at source and their subsequent improper management. Recently in India, non-governmental organizations (NGOs) and other civil society organizations have increasingly started to get involved in improving waste management services. Municipal solid waste management being a governmental function, the contribution of NGOs in this field has not been well documented. This study highlights the activities and services of Shuddham, an NGO functioning in the town of Puducherry within the Union Territory of Puducherry in South India. The NGO program promoted much needed awareness and education, encouraged source separation, enhanced door-to-door collection, utilized wastes as raw materials and generated more job opportunities. Even though source separation prior to door-to-door collection is a relatively new concept, a significant percentage of residents (39%) in the study area participated fully, while a further 48% participated in the collection service. The average amount of municipal solid waste generated by residential units in the Raj Bhavan ward was 8582 kg/month of which 47% was recovered through active recycling and composting practices. The study describes the features and performance of NGO-mediated solid waste management, and evaluates the strengths and weaknesses as well as the opportunities and threats of this system to see whether this model can sustainably replace the low-performance conventional solid waste management in practice in the town of Puducherry. The experiences from this case study are expected to provide broad guidelines to better understand the role of NGOs and their contributions towards sustainable waste management practices in urban areas. © The Author(s) 2014.

Changing trends in barriers to cataract surgery in India.

PubMed

Vaidyanathan, K; Limburg, H; Foster, A; Pandey, R M

1999-01-01

Cataract is a major cause of blindness in Asia. Efforts in India to provide cataract surgical services have had limited success in reaching the cataract-blind population. Earlier studies identified the major barriers to cataract surgery as poverty, lack of transportation or felt need, or sex related; and the critical barriers in rural areas as lack of awareness, difficult access, and cost. Compared with these earlier data, the results of the present study in Karnataka State indicate a shift in the character of the barriers. They now appear to be more related to case selection and service provision. These shifts are analysed and alternative strategies to increase the uptake to cataract surgery are recommended.

Frequency of HIV infection amongst children with disseminated tuberculosis and tuberculous meningitis in Aligarh (North India) - a low HIV prevalence area.

PubMed

Ramzan, Mohammad; Ali, Syed Manazir; Malik, Abida; Zaka-ur-Rab, Zeeba; Shahab, Tabassum

2009-09-01

To determine frequency of HIV in children with disseminated tuberculosis and tuberculous meningitis in a low HIV prevalence area, and to study clinical profile of those found HIV positive. Cross-sectional, descriptive study. Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India from February 2005 to January 2008. The study was conducted on 215 children under 14 years of age with either disseminated tuberculosis or tuberculous meningitis. HIV infection was diagnosed in accordance with WHO strategy II. In children younger than 18 months, the strategy (to cut down costs) was to screen first by HIV antibody testing and subject only positive cases to virological tests. Parents of HIV positive children were also tested for HIV and counselled. The clinical profile of HIV positive patients was noted. The frequency of HIV was 5.12%, while that in cases of disseminated tuberculosis was much higher (22%). No case with isolated tuberculous meningitis was HIV positive. The majority (45.45%) of patients with HIV were between 1-5 years of age. The mode of infection in 7 (63.63%) cases was parent to child transmission. Loss of weight, prolonged fever, pallor, hepato-splenomegaly and oral candidiasis were the commonest clinical manifestations among HIV positive patients. Clinically directed selective HIV screening in cases of disseminated tuberculosis can pickup undiagnosed cases of the same in areas with low prevalence of HIV infection.

Demographic and clinical profile of Multiple Sclerosis in Kashmir: A short report.

PubMed

Zahoor, Insha; Asimi, Ravouf; Haq, Ehtishamul; Yousuf Wani, Irfan

2017-04-01

Multiple sclerosis (MS) is a chronic autoimmune and inflammatory disease of the central nervous system (CNS). There have been only few population/hospital based studies on MS in India, and at the same time there is no data on its profile in Kashmir. A total of 41 MS patients diagnosed on the basis of 2010 Revised Mc Donald criteria were enrolled in this study from Kashmir region of India. Clinical, demographic, radiological and biochemical parameters were analyzed for most of the patients. Male to female ratio was found to be 1:3.1 with mean age at the time of analysis 32.26±7.54 (range 18-48) years. The mean disease duration was found to be 3.2±3.6 years. The most common course was relapsing-remitting (RR) present in 87.80% of cases followed by secondary progressive (SP) in 9.76% and primary progressive (PP) in 2.44%. Numbness, weakness of limbs, prickling and tingling sensations, muscle stiffness, and visual disturbances were most common manifestations. Condition of bilateral internuclear ophthalmoplegia (INO) and vertigo was rarely observed. Oligoclonal bands (OCB) were present in cerebrospinal fluid (CSF) of majority of the patients. Symptomatic and steroidal treatment mode was given to majority of the patients (92.68%) and only 7.32% patients were given disease modifying drug. This is the first preliminary report on MS profile in Kashmir. The high prevalence of female patients and RR course of MS, low prevalence of progressive cases, predominance of OCB positive cases, insignificant family history in all cases, predominance of cases with low socio-economic status, and high rate of less educated and unemployed cases are the most important findings. By and large MS pattern in Kashmir was found to be relatively similar to West and rest of the Asia. Larger comprehensive studies are mandatory to completely understand MS pattern in Kashmir. There is utmost requirement to maintain a local MS registry in Kashmir so as to get an idea about the actual number of persons suffering from the disease and compare the data with other regions of India. Copyright © 2017 Elsevier B.V. All rights reserved.

A cross-sectional study of polycystic ovarian syndrome among adolescent and young girls in Mumbai, India

PubMed Central

Joshi, Beena; Mukherjee, Srabani; Patil, Anushree; Purandare, Ameya; Chauhan, Sanjay; Vaidya, Rama

2014-01-01

Introduction: Polycystic ovary disease is a common endocrine condition which is rapidly gaining epidemic proportions. No community based prevalence data is available for this syndrome in India. Materials and Methods: A cross-sectional community-based study was undertaken in a sampled census block of Mumbai to assess the prevalence of polycystic ovarian syndrome (PCOS) among 778 adolescents and young girls aged 15-24 years. Among them, 600 completed all clinical, ultrasonography (USG), and biochemical investigations. Results: The prevalence of PCOS among them was 22.5% by Rotterdam and 10.7% by Androgen Excess Society criteria. Nonobese comprised 71.8% of PCOS diagnosed by Rotterdam criteria. Mild PCOS (oligomenorrhea and polycystic ovaries on USG) was the most common phenotype (52.6%). History of oligomenorrhea had a positive predictive value of 93.3% and negative predictive value of 86.7% to detect a possible case of PCOS. Hyperinsulinemia (serum insulin >15 μlU/mL) was present among 19.2% of diagnosed PCOS cases. Obese girls with PCOS were more hirsute, hypertensive, and had significantly higher mean insulin and 2 h post 75 g glucose levels compared with nonobese PCOS. Conclusion: To our knowledge, this is the first urban community-based study diagnosing PCOS and phenotypes among adolescent and young girls in India. This study demonstrates that PCOS is an emerging disorder during adolescence and screening could provide opportunity to target the group for promoting healthy lifestyles and early interventions to prevent future morbidities. PMID:24944925

Data Entry Skills in a Computer-based Spread Sheet Amongst Postgraduate Medical Students: A Simulation Based Descriptive Assessment.

PubMed

Khan, Amir Maroof; Shah, Dheeraj; Chatterjee, Pranab

2014-07-01

In India, research work in the form of a thesis is a mandatory requirement for the postgraduate (PG) medical students. Data entry in a computer-based spread sheet is one of the important basic skills for research, which has not yet been studied. This study was conducted to assess the data entry skills of the 2(nd) year PG medical students of a medical college of North India. A cross-sectional, descriptive study was conducted among 111 second year PG students by using four simulated filled case record forms and a computer-based spread sheet in which data entry was to be carried out. On a scale of 0-10, only 17.1% of the students scored more than seven. The specific sub-skills that were found to be lacking in more than half of the respondents were as follows: Inappropriate coding (93.7%), long variable names (51.4%), coding not being done for all the variables (76.6%), missing values entered in a non-uniform manner (84.7%) and two variables entered in the same column in the case of blood pressure reading (80.2%). PG medical students were not found to be proficient in data entry skill and this can act as a barrier to do research. This being a first of its kind study in India, more research is needed to understand this issue and then include this yet neglected aspect in teaching research methodology to the medical students.

Type 1 diabetes in India: Overall insights.

PubMed

Das, Ashok Kumar

2015-04-01

Type 1 diabetes mellitus (T1DM) is also on increase like type 2 diabetes, even though not in the same proportion, but still with a trend of 3-5% increase/year. India has three new cases of T1DM/100,000 children of 0-14 years. Three sets of prevalence data shows 17.93 cases/100,000 children in Karnataka, 3.2 cases/100,000 children in Chennai, and 10.2 cases/100,000 children in Karnal (Haryana). T1DM may be autoimmune or idiopathic in nature and is present in 9% cases of insulin deficiency. T1DM is primarily caused by genetic factors, environmental factors, and disorder of the immune regulatory mechanism. A combination of all these three factors causes autoimmune disease, which may ultimately result in the destruction of pancreatic beta cells leading to hyperglycemia, ketoacidosis and potentially death, if not treated with insulin. Prediabetes is the phase before the onset of T1DM, which provides a window of opportunity for early intervention. All available interventions including steroids, immunosuppressants, and cyclosporins can be possibly applied during the prediabetes phase. The treatment goals for T1DM are simple and include maintaining near normal blood glucose levels and avoiding long-term complications, which is a constant juggle between insulin and maintaining an appropriate lifestyle. The Indian Council of Medical Research funded Registry of People with diabetes in India with young age at onset (YDR) was started in the year 2006 with 10 collaborating centres across India. This registry is focusing on to provide an overview of diabetes in the young.

Identification of mongoose (genus: Herpestes) species from hair through band pattern studies using discriminate functional analysis (DFA) and microscopic examination.

PubMed

Sahajpal, Vivek; Goyal, S P; Raza, R; Jayapal, R

2009-09-01

India is home to seven species of mongoose (Herpestes sp). Mongooses are being poached primarily for their hair, which is used in the production of painting and shaving brushes. Prior to September 2002, mongooses were listed under Schedule-IV of the Wildlife (Protection) Act 1972 (India). Indiscriminate poaching of the mongoose created an immediate threat to their survival and hence mongooses have now been placed under Schedule-II of the Wildlife (Protection) Act-1972 (India). In order to convict a person under this legislation, species identification of case related samples is necessary. Four species of mongoose i.e. H. edwardsii, H. smithii, H. palustris and H. urva were characterised by performing discriminate functional analysis (DFA) on measurements of their dorsal guard hair banding pattern and by microscopic hair characteristics (Cuticular, medullar and cross section). It was possible to distinguish between the four species studied, based on both these methods.

Gender, mass media and social change: a case study of TV commercials.

PubMed

Gupta, A K; Jain, N

1998-01-01

Informing, entertaining, and persuading, mass media, especially television, is a powerful factor in the functioning of and change in any society. Mass media can be studied in its various roles as an agent of social change, a reflector of dominant values, and as a reinforcer of dominant values. Results from a 1997 spot survey of 150 television commercials presented on Doordarshan over a 4-week period support the role of the mass media in India as a reflector and reinforcer of dominant cultural values. By indirectly projecting the social norms on how women are expected to behave, television commercials have reproduced patriarchal values in India which are reinforced through the glamorization and naturalization of women's domestic roles, by glorifying the role of mother, by portraying women in public life in soft roles and subordinate jobs, and popularizing the image of women as sex objects and objects of beauty. Changes should be made in the way television in India portrays women to reflect their changing roles and positions in society.

Benefits and Pitfalls of GRACE Data Assimilation: a Case Study of Terrestrial Water Storage Depletion in India

PubMed Central

Girotto, Manuela; De Lannoy, Gabriëlle J. M.; Reichle, Rolf H.; Rodell, Matthew; Draper, Clara; Bhanja, Soumendra N.; Mukherjee, Abhijit

2018-01-01

This study investigates some of the benefits and drawbacks of assimilating Terrestrial Water Storage (TWS) observations from the Gravity Recovery and Climate Experiment (GRACE) into a land surface model over India. GRACE observes TWS depletion associated with anthropogenic groundwater extraction in northwest India. The model, however, does not represent anthropogenic groundwater withdrawals and is not skillful in reproducing the interannual variability of groundwater. Assimilation of GRACE TWS introduces long-term trends and improves the interannual variability in groundwater. But the assimilation also introduces a negative trend in simulated evapotranspiration whereas in reality evapotranspiration is likely enhanced by irrigation, which is also unmodeled. Moreover, in situ measurements of shallow groundwater show no trend, suggesting that the trends are erroneously introduced by the assimilation into the modeled shallow groundwater, when in reality the groundwater is depleted in deeper aquifers. The results emphasize the importance of representing anthropogenic processes in land surface modeling and data assimilation systems. PMID:29643570

Benefits and Pitfalls of GRACE Data Assimilation: a Case Study of Terrestrial Water Storage Depletion in India.

PubMed

Girotto, Manuela; De Lannoy, Gabriëlle J M; Reichle, Rolf H; Rodell, Matthew; Draper, Clara; Bhanja, Soumendra N; Mukherjee, Abhijit

2017-05-16

This study investigates some of the benefits and drawbacks of assimilating Terrestrial Water Storage (TWS) observations from the Gravity Recovery and Climate Experiment (GRACE) into a land surface model over India. GRACE observes TWS depletion associated with anthropogenic groundwater extraction in northwest India. The model, however, does not represent anthropogenic groundwater withdrawals and is not skillful in reproducing the interannual variability of groundwater. Assimilation of GRACE TWS introduces long-term trends and improves the interannual variability in groundwater. But the assimilation also introduces a negative trend in simulated evapotranspiration whereas in reality evapotranspiration is likely enhanced by irrigation, which is also unmodeled. Moreover, in situ measurements of shallow groundwater show no trend, suggesting that the trends are erroneously introduced by the assimilation into the modeled shallow groundwater, when in reality the groundwater is depleted in deeper aquifers. The results emphasize the importance of representing anthropogenic processes in land surface modeling and data assimilation systems.

Benefits and Pitfalls of GRACE Data Assimilation: A Case Study of Terrestrial Water Storage Depletion in India

NASA Technical Reports Server (NTRS)

Girotto, Manuela; De Lannoy, Gabrielle J. M.; Reichle, Rolf H.; Rodell, Matthew; Draper, Clara S.; Bhanja, Soumendra N.; Mukherjee, Abhijit

2017-01-01

This study investigates some of the benefits and drawbacks of assimilating Terrestrial Water Storage (TWS) observations from the Gravity Recovery and Climate Experiment (GRACE) into a land surface model over India. GRACE observes TWS depletion associated with anthropogenic groundwater extraction in northwest India. The model, however, does not represent anthropogenic groundwater withdrawals and is not skillful in reproducing the interannual variability of groundwater. Assimilation of GRACE TWS introduces long-term trends and improves the interannual variability in groundwater. But the assimilation also introduces a negative trend in simulated evapotranspiration whereas in reality evapotranspiration is likely enhanced by irrigation, which is also unmodeled. Moreover, in situ measurements of shallow groundwater show no trend, suggesting that the trends are erroneously introduced by the assimilation into the modeled shallow groundwater, when in reality the groundwater is depleted in deeper aquifers. The results emphasize the importance of representing anthropogenic processes in land surface modeling and data assimilation systems.

Contextualized Science for Teaching Science and Technology.

ERIC Educational Resources Information Center

Koul, Ravinder; Dana, Thomas M.

1997-01-01

Discusses science education in India, arguing that a contextualized curriculum is a powerful means of improvement. The paper presents results from an analysis of the treatment of the nature of science and technology in current Indian textbooks and uses India's controversial Sadar Sarovar Hydro-Electric Project as a case example. (SM)

Future trends in computer waste generation in India.

PubMed

Dwivedy, Maheshwar; Mittal, R K

2010-11-01

The objective of this paper is to estimate the future projection of computer waste in India and to subsequently analyze their flow at the end of their useful phase. For this purpose, the study utilizes the logistic model-based approach proposed by Yang and Williams to forecast future trends in computer waste. The model estimates future projection of computer penetration rate utilizing their first lifespan distribution and historical sales data. A bounding analysis on the future carrying capacity was simulated using the three parameter logistic curve. The observed obsolete generation quantities from the extrapolated penetration rates are then used to model the disposal phase. The results of the bounding analysis indicate that in the year 2020, around 41-152 million units of computers will become obsolete. The obsolete computer generation quantities are then used to estimate the End-of-Life outflows by utilizing a time-series multiple lifespan model. Even a conservative estimate of the future recycling capacity of PCs will reach upwards of 30 million units during 2025. Apparently, more than 150 million units could be potentially recycled in the upper bound case. However, considering significant future investment in the e-waste recycling sector from all stakeholders in India, we propose a logistic growth in the recycling rate and estimate the requirement of recycling capacity between 60 and 400 million units for the lower and upper bound case during 2025. Finally, we compare the future obsolete PC generation amount of the US and India. Copyright © 2010 Elsevier Ltd. All rights reserved.

Foreign Assistance and Its Impact on Civil-Military Relations: A Case Study of Federal Democratic Republic of Nepal

DTIC Science & Technology

2014-03-01

China activities and keeping Nepal away from being too dependent in India. While assisting Kathmandu, Beijing is consciously making strategic inroads...112 Campbell, “Nepal Case Study,” 5. 113 M Humagain, “Aid Quantum : China the Rising Sun on Nepal Economic...military/library/congress/2006_hr/060407- hillen.pdf. Humagain, M. “Aid Quantum : China the Rising Sun on Nepal Economic Horizon.” Kathmandu Post

Disease burden due to biomass cooking-fuel-related household air pollution among women in India

PubMed Central

Sehgal, Meena; Rizwan, Suliankatchi Abdulkader; Krishnan, Anand

2014-01-01

Background Household air pollution (HAP) due to biomass cooking fuel use is an important risk factor for a range of diseases, especially among adult women who are primary cooks, in India. About 80% of rural households in India use biomass fuel for cooking. The aim of this study is to estimate the attributable cases (AC) for four major diseases/conditions associated with biomass cooking fuel use among adult Indian women. Methods We used the population attributable fraction (PAF) method to calculate the AC of chronic bronchitis, tuberculosis (TB), cataract, and stillbirths due to exposure to biomass cooking fuel. A number of data sources were accessed to obtain population totals and disease prevalence rates. A meta-analysis was conducted to obtain adjusted pooled odds ratios (ORs) for strength of association. Using this, PAF and AC were calculated using a standard formula. Results were presented as number of AC and 95% confidence intervals (CI). Results The fixed effects pooled OR obtained from the meta-analysis were 2.37 (95% CI: 1.59, 3.54) for chronic bronchitis, 2.33 (1.65, 3.28) for TB, 2.16 (1.42, 3.26) for cataract, and 1.26 (1.12, 1.43) for stillbirths. PAF varied across conditions being maximum (53%) for chronic bronchitis in rural areas and least (1%) for cataract in older age and urban areas. About 2.4 (95% CI: 1.4, 3.1) of 5.6 m cases of chronic bronchitis, 0.3 (0.2, 0.4) of 0.76 m cases of TB, 5.0 (2.8, 6.7) of 51.4 m cases of cataract among adult Indian women and 0.02 (0.01, 0.03) of 0.15 m stillbirths across India are attributable to HAP due to biomass cooking fuel. These estimates should be cautiously interpreted in the light of limitations discussed which relate to exposure assessment, exposure characterization, and age-specific prevalence of disease. Conclusions HAP due to biomass fuel has diverse and major impacts on women’s health in India. Although challenging, incorporating the agenda of universal clean fuel access or cleaner technology within the broader framework of rural development will go a long way in reducing disease burden. PMID:25373414

Dementia in developing countries: Does education play the same role in India as in the West?

PubMed

Iyer, Gowri K; Alladi, Suvarna; Bak, Thomas H; Shailaja, Mekala; Mamidipudi, Annapurna; Rajan, Amulya; Gollahalli, Divyaraj; Chaudhuri, Jaydip Ray; Kaul, Subhash

2014-01-01

Evidence suggests that education protects from dementia by enhancing cognitive reserve. However, this may be influenced by several socio-demographic factors. Rising numbers of dementia in India, high levels of illiteracy and heterogeneity in socio-demographic factors provide an opportunity to explore this relationship. To study the association between education and age at dementia onset, in relation to socio-demographic factors. Association between age at dementia onset and literacy was studied in relationship to potential confounding factors such as gender, bilingualism, place of dwelling, occupation, vascular risk factors, stroke, family history of dementia and dementia subtypes. Case records of 648 dementia patients diagnosed in a specialist clinic in a University hospital in Hyderabad, India were examined. All patients were prospectively enrolled as part of an ongoing longitudinal project that aims to evaluate dementia subjects with detailed clinical, etiological, imaging, and follow-up studies. Of the 648 patients, 98 (15.1%) were illiterate. More than half of illiterate skilled workers were engaged in crafts and skilled agriculture unlike literates who were in trade or clerical jobs. Mean age at onset in illiterates was 60.1 years and in literates 64.5 years (p=0.0002). Factors independently associated with age at dementia onset were bilingualism, rural dwelling and stroke, but not education. Our study demonstrates that in India, rural dwelling, bilingualism, stroke and occupation modify the relationship between education and dementia.

Assessing resident awareness on e-waste management in Bangalore, India: a preliminary case study.

PubMed

Awasthi, Abhishek Kumar; Li, Jinhui

2018-04-01

The generation of e-waste has increased significantly in India, and the informal recycling of e-waste has adverse effects on environment and public health. In this article, the E-waste management is evaluated in accordance from the resident's awareness perspective in Bangalore city, India. The survey data revealed that about 58% male and 42% female responded and 35% of the participants belong to age range between 18 and 25 years. About 60% of respondent's education level was either graduate or post graduate, 27% high school to higher school, 10% higher educated (> post graduate), and 3% primary to middle. Only 30% of the respondents were confident with e-waste rules and regulation, while 39% of the respondents were of very little information. Indian e-waste management has been improving for the last few years and it continues to develop. Therefore, the findings can be valuable for better understanding the resident's awareness for e-waste management and also need to promote the environmentally sound management of e-waste in Bangalore, India.

Survey of ethical issues reported by Indian medical students: basis for design of a new curriculum.

PubMed

Rose, Anuradha; George, Kuryan; T, Arul Dhas; Pulimood, Anna Benjamin

2014-01-01

Education in ethics is now a formal part of the undergraduate medical curriculum. However, most courses are structured around principles and case studies more appropriate to western countries. The cultures and practices of countries like India differ from those of western countries. It is, therefore, essential that our teaching should address the issues which are the most relevant to our setting. An anonymised, questionnaire-based, cross-sectional survey of medical students was carried out to get a picture of the ethical problems faced by students in India. The data were categorised into issues related to professional behaviour and ethical dilemmas. Unprofessional behaviour was among the issues reported as a matter of concern by a majority of the medical students. The survey highlights the need to design the curriculum in a way that reflects the structure of medical education in India, where patients are not always considered socio-culturally equal by students or the medical staff. This perspective must underpin any further efforts to address education in ethics in India.

Oseltamivir-resistant influenza A(H1N1)pdm09 virus associated with high case fatality, India 2015.

PubMed

Tandel, Kundan; Sharma, Shashi; Dash, Paban Kumar; Parida, ManMohan

2018-05-01

Influenza A viruses has been associated with severe global pandemics of high morbidity and mortality with devastating impact on human health and global economy. India witnessed a major outbreak of influenza A(H1N1)pdm09 in 2015. This study comprises detailed investigation of cases died of influenza A(H1N1)pdm09 virus infection during explosive outbreak of 2015, in central part of India. To find out presence of drug resistant virus among patients who died of influenza A(H1N1)pdm09 virus infection and to find out presence of other mutations contributing to the morbidity and mortality. Twenty-two patients having confirmed influenza A(H1N1)pdm09 infection and subsequently died of this infection along with 20 non fatal cases with influenza A(H1N1)pdm09 infection were included in the study. Samples were investigated through RT-PCR/RFLP analysis, followed by nucleotide cycle sequencing of whole NA gene for detection of H275Y amino acid substitution in NA gene responsible for oseltamivir drug resistance. Out of 22 fatal cases, 6 (27.27%) were found to harbor oseltamivir resistant virus strains, whereas the H275Y mutation was not observed among the 20 non fatal cases. Amino acid substitution analysis of complete NA gene revealed V241I, N369K, N386K substitution in all strains playing synergistic role in oseltamivir drug resistance. High morbidity and mortality associated with influenza A(H1N1)pdm09 viruses can be explained by presence of drug resistant strains circulating in this outbreak. Presence of Oseltamivir resistant influenza A(H1N1)pdm09 viruses is a cause of great concern and warrants continuous screening for the circulation of drug resistant strains. © 2017 Wiley Periodicals, Inc.

Spectrum of clinical disease in a series of 135 hospitalised HIV-infected patients from north India

PubMed Central

Sharma, SK; Kadhiravan, Tamilarasu; Banga, Amit; Goyal, Tarun; Bhatia, Indrish; Saha, PK

2004-01-01

Background Literature on the spectrum of opportunistic disease in human immunodeficiency virus (HIV)-infected patients from developing countries is sparse. The objective of this study was to document the spectrum and determine the frequency of various opportunistic infections (OIs) and non-infectious opportunistic diseases, in hospitalised HIV-infected patients from north India. Methods One hundred and thirty five consecutive, HIV-infected patients (age 34 ± 10 years, females 17%) admitted to a tertiary care hospital in north India, for the evaluation and management of an OI or HIV-related disorder between January 2000 and July 2003, were studied. Results Fever (71%) and weight loss (65%) were the commonest presenting symptoms. Heterosexual transmission was the commonest mode of HIV-acquisition. Tuberculosis (TB) was the commonest OI (71%) followed by candidiasis (39.3%), Pneumocystis jiroveci pneumonia (PCP) (7.4%), cryptococcal meningitis and cerebral toxoplasmosis (3.7% each). Most of the cases of TB were disseminated (64%). Apart from other well-recognised OIs, two patients had visceral leishmaniasis. Two cases of HIV-associated lymphoma were encountered. CD4+ cell counts were done in 109 patients. Majority of the patients (82.6%) had CD4+ counts <200 cells/μL. Fifty patients (46%) had CD4+ counts <50 cells/μL. Only 50 patients (37%) received antiretroviral therapy. Twenty one patients (16%) died during hospital stay. All but one deaths were due to TB (16 patients; 76%) and PCP (4 patients; 19%). Conclusions A wide spectrum of disease, including both OIs and non-infectious opportunistic diseases, is seen in hospitalised HIV-infected patients from north India. Tuberculosis remains the most common OI and is the commonest cause of death in these patients. PMID:15555069

Evolving herbal formulations in management of dengue fever.

PubMed

Singh, Pawan Kumar; Rawat, Pooja

Dengue is endemic in more than 100 countries and it is estimated that annually above 390 million infections occur globally. During the period between 1996-2015, a massive increase of more than 500 per cent has been recorded in number of dengue cases reported in India. Till date, there are no specific globally accepted treatments for dengue fever in any system of medicine. Dengue does not cause very high mortality if properly handled and is currently being managed by clinicians through various adjuvant and alternative therapeutic options. Various plant based preparations have been used in different parts of India for combating dengue and are simultaneously also being scientifically validated by researchers. However, number of such scientific validation studies on phytomedicines are very less in India. Out of twenty-two plants reported against dengue, only four have been studied scientifically. Azadirachta indica, Carica papaya, Hippophae rhamnoides and Cissampelos pareira extracts were found effective and demonstrated improvement in clinical symptoms and direct inhibitory effect on dengue virus. C. papaya clinical trial showed increase in platelet count and faster recovery. These plants may be explored further as probable candidates for drug discovery against dengue. There is a need to search more such herbal formulations, which are being practiced at local level, document properly and validate them scientifically to confirm efficacy, mechanistic action and safety, before use. The herbal formulations being used by communities are the low hanging fruits which may provide alternative or adjuvant therapy if proper validation, value addition and product development steps are followed. This paper aims to review the recent status of dengue cases, deaths and evolving curative herbal solutions adapted and reported from India to combat the disease. Copyright © 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.

Imbalance in leptin-adiponectin levels and leptin receptor expression as chief contributors to triple negative breast cancer progression in Northeast India.

PubMed

Sultana, Rizwana; Kataki, Amal Ch; Borthakur, Bibhuti Bhusan; Basumatary, Tarun K; Bose, Sujoy

2017-07-20

Triple-Negative breast cancer (TNBC), accounts for a large percentage of breast cancer cases in India including Northeast India. TNBC has an unclear molecular aetiology and hence limited targeted therapies. Human breast is comprised of glandular, ductal, connective, and adipose tissues. Adipose tissue is composed of adipocytes. The adipocytes apart from being energy storage depots, are also active sources of adipocytokines and/or adipokines. The role of adipokines in breast cancer including TNBC has been sporadically documented. Two adipokines in particular, leptin and adiponectin, have come to be recognized for their influence on breast cancer risk and tumour biology. Therefore, the aim of this study was to understand the association of differential expression of critical adipokines and associated cellular mechanism in the susceptibility and severity of TNBC in northeast Indian population. We collected 68 TNBC and 63 controls cases and examined for serum leptin and adiponectin levels using enzyme linked immunosorbent assay (ELISA). Leptin Receptor (Ob-R) mRNA expression was determined by real-time polymerase chain reaction (RT-PCR) assay. Differential Ob-R mRNA expression and correlation with cancer stem cell (CSC) markers was evaluated, and correlated with severity. The serum leptin levels were significantly associated with TNBC severity, while the adiponectin levels were comparative. The serum leptin levels correlated inversely with the adiponetin levels. Serum leptin levels were unaffected with difference in parity. The difference in leptin levels in pre and post menopausal cases were found to be statistically non-significant. Higher leptin levels were also found to be associated obesity, mortality and recurrence. Obesity was found to be a factor for TNBC pathogenesis and severity. Increased Ob-R mRNA expression was associated with TNBC, significantly with TNBC severity, and was significantly higher in obese patients with higher grade TNBC cases. The Ob-R gene mRNA expression was significantly higher in the obese TNBC cases showing recurrence or mortality. The higher Ob-R gene mRNA expression correlated significantly with higher serum leptin levels and lower serum adiponectin levels in TNBC cases. The Ob-R mRNA expression with associated with modulation of CSC oct4 and nanog. In conclusion, the present study is first of its kind on TNBC from northeast India, indicates that adipocytokines does play a role in TNBC pathogenesis. Thus, the understanding of molecular mechanisms of both leptin and adiponectin and their interplay in TNBC offer the prospects for new therapeutic approaches targeting similar signalling pathways. Copyright © 2017 Elsevier B.V. All rights reserved.

Ertapenem-Induced Acute Interstitial Nephritis (AIN) in a Case of Protein S Deficiency and Factor V Leiden Mutation with Deep Vein Thrombosis.

PubMed

Rathod, Nitin; Pai, Pavan

2016-03-01

We present a case of 58 years old male patient, who presented with high fever for which injection Ertapenem was started empirically at Dubai hospital. Patient was a known case of Deep vein thrombosis of left leg since 5 years on warfarin therapy. Patient came to India for high fever and further management. Patient developed proteinuria with high creatinine and urinary abnormalities. Renal biopsy revealed acute interstitial nephritis (AIN). In addition, he was diagnosed to have protein S deficiency with Factor V Leiden mutation. © Journal of the Association of Physicians of India 2011.

Moving toward Socially and Environmentally Responsible Management Education--A Case Study of Mumbai

ERIC Educational Resources Information Center

Goyal, Ela; Gupta, Mahendra

2014-01-01

Educational institutions have a vital role to play shaping the future of our environment. Education provides opportunities for students to become environmentally conscious citizens besides being educated. In this study, an attempt has been made to study the perception of management students and teachers in the city of Mumbai, India, to determine…

Improving tuberculosis control through public-private collaboration in India: literature review.

PubMed

Dewan, Puneet K; Lal, S S; Lonnroth, Knut; Wares, Fraser; Uplekar, Mukund; Sahu, Suvanand; Granich, Reuben; Chauhan, Lakhbir Singh

2006-03-11

To review the characteristics of public-private mix projects in India and their effect on case notification and treatment outcomes for tuberculosis. Literature review. Review of surveillance records from Indian tuberculosis programme project, evaluation reports, and medical literature for public-private mix projects in India. Project characteristics, tuberculosis case notification of new patients with sputum smear results positive for acid fast bacilli, and treatment outcome. Of 24 identified public-private mix projects, data were available from 14 (58%), involving private practitioners, corporations, and non-governmental organisations. In all reviewed projects, the public sector tuberculosis programme provided training and supervision of private providers. Among the five projects with available data on historical controls, case notification rates were higher after implementation of a public-private mix project. Among seven projects involving private practitioners, 2796 of 12 147 (23%) new patients positive for acid fast bacilli were attributed to private providers. Corporate based and non-governmental organisations served as the main source for tuberculosis programme services in seven project areas, detecting 9967 new patients positive for acid fast bacilli. In nine of 12 projects with data on treatment outcomes, private providers exceeded the programme target of 85% treatment success for new patients positive for acid fast bacilli. Public-private mix activities were associated with increased case notification, while maintaining acceptable treatment outcomes. Collaborations between public and private providers of health care hold considerable potential to improve tuberculosis control in India.

School Enterprises: Combining Vocational Learning with Production. International Project on Technical and Vocational Education (UNEVOC).

ERIC Educational Resources Information Center

Singh, Madhu

Trends in combining learning and production were examined through case studies of school enterprises in 11 countries: China, India, Indonesia, Papua New Guinea, Germany, Botswana, Kenya, Ghana, Algeria, Cuba, and Costa Rica. The study focused on the following: types and structures of school enterprises; organization of learning; competency…

Impact assessment of on-site sanitation system on groundwater quality in alluvial settings: A case study from Lucknow city in North India.

PubMed

Jangam, Chandrakant; Ramya Sanam, S; Chaturvedi, M K; Padmakar, C; Pujari, Paras R; Labhasetwar, Pawan K

2015-10-01

The present case study has been undertaken to investigate the impact of on-site sanitation on groundwater quality in alluvial settings in Lucknow City in India. The groundwater samples have been collected in the areas of Lucknow City where the on-site sanitation systems have been implemented. The groundwater samples have been analyzed for the major physicochemical parameters and fecal coliform. The results of analysis reveal that none of the groundwater samples exceeded the Bureau of Indian Standards (BIS) limits for all the parameters. Fecal coliform was not found in majority of the samples including those samples which were very close to the septic tank. The study area has a thick alluvium cover as a top layer which acts as a natural barrier for groundwater contamination from the on-site sanitation system. The t test has been performed to assess the seasonal effect on groundwater quality. The statistical t test implies that there is a significant effect of season on groundwater quality in the study area.

The Dragon and the Tiger: Realties in the Control of Tuberculosis

PubMed Central

Bhatter, P.; Chatterjee, A.; Mistry, N.

2012-01-01

India and China are two Asian super-powers with developing economies carried on the shoulders of their booming populations. This growth can only be sustained by nurturing their “human resource”. However increasing reports of insufficient public health (PH) initiatives in India when compared to the aggressive PH system of China may prove to be the Achilles' heels for India. This review compares the PH system in India and China for combating Tuberculosis (TB), the disease responsible for maximum mortality and morbidity by a single infectious agent. While China has acknowledged the disease load and thereafter has methodically improved its reporting, detection, diagnosis and treatment, India is still in denial of the imminent health risk. The Indian PH system still considers TB as a “facultative” disease for which the required control measures are already in place and functioning. Globally, India and China recorded the highest Multi-Drug Resistant TB (MDR) cases notified in 2010 (64000 and 63000, respectively). Additionally non-government sources reported extremely high proportions of MDR in India. Here we have compared the medical, social and economic approaches of the two nations towards better management and control of TB. Does India have lessons to learn from China? PMID:22829815

Opportunities and Challenges for Solar Minigrid Development in Rural India

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thirumurthy, N.; Harrington, L.; Martin, D.

2012-09-01

The goal of this report is to inform investors about the potential of solar minigrid technologies to serve India's rural market. Under the US-India Energy Dialogue, the US Department of Energy's (DOE) National Renewable Energy Laboratory (NREL) is supporting the Indian Ministry of New and Renewable Energy (MNRE)'s Jawaharlal Nehru National Solar Mission (JNNSM) in performing a business-case and policy-oriented analysis on the deployment of solar minigrids in India. The JNNSM scheme targets the development of 2GW of off-grid solar power by 2022 and provides large subsidies to meet this target. NREL worked with electricity capacity and demand data suppliedmore » by the Ladakh Renewable Energy Development Agency (LREDA) from Leh District, to develop a technical approach for solar minigrid development. Based on the NREL-developed, simulated solar insolation data for the city of Leh, a 250-kW solar photovoltaic (PV) system can produce 427,737 kWh over a 12-month period. The business case analysis, based on several different scenarios and JNNSM incentives shows the cost of power ranges from Rs. 6.3/kWh (US$0.126) to Rs. 9/kWh (US$0.18). At these rates, solar power is a cheaper alternative to diesel. An assessment of the macro-environment elements--including political, economic, environmental, social, and technological--was also performed to identify factors that may impact India?s energy development initiatives.« less

Mutation analysis of β-thalassemia in East-Western Indian population: a recent molecular approach

PubMed Central

Shah, Parth S; Shah, Nidhi D; Ray, Hari Shankar P; Khatri, Nikunj B; Vaghasia, Ketan K; Raval, Rutvik J; Shah, Sandip C; Rao, Mandava V

2017-01-01

Background β-Thalassemia is the most prevalent genetic disorder in India. Its traits and coinheritance vary from mild to severe conditions, resulting in thalassemia minor, intermediate, and major, depending upon many factors. Purpose The objective of this study was to identify the incidence of β-thalassemia traits, their coinheritance, and mutations, as well as to support the patients already diagnosed with β-thalassemia in East-Western Indian population for better management. Patients and methods Seventy-five referral cases for β-thalassemia were analyzed for various β-thalassemia traits, heterozygosity, and homozygosity conditions. Blood phenotypic parameters using cell counter and capillary electrophoresis were investigated. Analyses of eight common mutations of thalassemia in India were carried out using polymerase chain reaction-amplification refractory mutation system, end point polymerase chain reaction, and DNA sequencing methods. Results Of these (75) referral cases from East-Western Indian region, 68 were positive for β-thalassemia (90.67%). The majority of case types were of β-thalassemia minor (49, 65.33%), followed by HbE traits (6, 8.0%) and β-thalassemia major, including heterozygous and homozygous (5, 6.66%; 4, 5.33%) types and then HbE homozygous (2, 2.66%), as well as one each of the HbE/β-thalassemia and HbD/β-thalassemia (1, 1.34%) combination. Mutation analysis also revealed that the highest frequency of mutation was c.92+5G>C (41, 60.29%) followed by deletion 619bp (9, 13.23%) and c.79G>A (8, 11.76%) in our study group. Five cases (nos. 24, 27, 33, 58, and 71) exhibited coinheritance between β0/β+ (2), β0/β D (1), and c.124_127delTTCT/β+ or β0(2) affecting the Rajasthani and Gujarati populations in our study of the Western region of India. Conclusion We strongly recommend these Western populations for genetic screening before adopting reproductive technologies and interracial marital relations. PMID:28546763

Autopsy audit of intentional burns inflicted by self or by others in north India-5 year snapshot.

PubMed

Kumar, Sachil; Verma, Anoop K; Singh, Uma Shankar; Singh, Raghvendra

2015-10-01

The incidence of suicide and homicide is on the increase worldwide, including India. One million people die annually due to suicides and homicides alone. Thus this study had been undertaken to find out the material and social causes of burn and to assess the socio-demographic characteristics between suicide and homicide. This retrospective study was carried out on 1393 fatal burn cases (2008-2012) who were autopsied at the mortuary of King George's Medical University, Lucknow, India. Data retrieved include: age, sex, type of family, marital status, place of incidence, psychological status and burn size (TBSA). The results were presented in Mean ± SD and percentages and analyzed with SPSS 16.0. Out of the total 1369 cases of burns, 536 cases (38.5%) were homicidal deaths in comparison to 857 cases (61.5%) of suicidal deaths. Female predominance was seen in both suicidal and homicidal deaths with peak age 30-39 years in suicides in contrast to 40-49 years in homicides. At younger age ≤19 years, the victims of suicide is almost similar to the victims of homicide; but at extremes of ages below 10 years and above 60 years, homicides were relatively more common than suicides. Married victims were predominant in the homicidal group (66.6%). There is no quite difference at the place where burn occurs. Depression and anxiety disorders were the most frequent psychiatric co-morbidities associated with suicidal behaviours. Patients from suicidal group suffered significantly larger burns than from homicidal group. Hence, this study was planned with a purpose to know the magnitude and the socio-cultural factors of the problem of burns to more clearly understand the dynamics surrounding these deaths, so that a sound prevention programme could be suggested, planned and implemented for reducing the incidence of fatal burns. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Postcolonial constructions of HIV/AIDS: meaning, culture, and structure.

PubMed

Sastry, Shaunak; Dutta, Mohan J

2011-01-01

As a field of inquiry, postcolonial health communication seeks to apprehend processes implicated in the construction of "primitive" versus "modern" with respect to issues of health. In the case of HIV/AIDS, the sociocultural representations of the disease have a profound impact on how the disease is configured medically and symbolically in dominant cultural imagination. Postcolonial constructions of disease are mobilized around the political and economic interests of the dominant power structures in global spaces. In this article, a thematic analysis of the constructions of HIV/AIDS in India in the mainstream U.S. news media was conducted. A corpus of news articles from the Lexis-Nexis database was created with the keywords "HIV," "AIDS," and "India." Three themes emerged from the study: (a) India as a site of biomedical control; (b) the economic logics of HIV/AIDS; and (c) AIDS, development, and the "Third World." Copyright © Taylor & Francis Group, LLC

Strategic alliance, a way forward for violence against women: a case for the Special Cells, India.

PubMed

Dave, Anjali

2013-10-01

This article attempts to describe the experiences of violated women and the struggles of social workers to contest violence against women in the Indian context. It begins with a brief account of an "indigenous model": the establishment of a service for violated women in India within the police force--the Special Cell on Violence Against Women. The article traces the strategic location, vision, growth, present position, expansion, and replication of the Special Cell in India, and discusses the necessity of working simultaneously with violated women, formal systems, and social structures; its contribution to the campaign for a Domestic Violence Act; and the resultant outcomes. The arduous nature of the work required for violated women and the women's own assessment of the Special Cells were accessed through a rigorous evaluation study, which is presented in the article, providing an answer and affirmation to the question: Why work with the Establishment--the State.

Preparing your Offshore Organization for Agility: Experiences in India

NASA Astrophysics Data System (ADS)

Srinivasan, Jayakanth

Two strategies that have significantly changed the way we conventionally think about managing software development and sustainment are the family of development approaches collectively referred to as agile methods, and the distribution of development efforts on a global scale. When you combine the two strategies, organizations have to address not only the technical challenges that arise from introducing new ways of working, but more importantly have to manage the 'soft' factors that if ignored lead to hard challenges. Using two case studies of distributed agile software development in India we illustrate the areas that organizations need to be aware of when transitioning work to India. The key issues that we emphasize are the need to recruit and retain personnel; the importance of teaching, mentoring and coaching; the need to manage customer expectations; the criticality of well-articulated senior leadership vision and commitment; and the reality of operating in a heterogeneous process environment.

Temporal trend of anemia among reproductive-aged women in India.

PubMed

Bharati, Susmita; Pal, Manoranjan; Som, Suparna; Bharati, Premananda

2015-03-01

Anemia is one of the major leading nutritional deficiencies in India, and the most vulnerable groups are preschool and adolescent children and pregnant and lactating women. The main objective of the study is to determine the temporal trend of anemia among reproductive-aged women of age 15-49 years. The study uses data from second and third rounds of the National Family Health Surveys (NFHS-2, 1998-1999, and NFHS-3, 2005-2006), conducted by the International Institute for Population Sciences. The dependent variable was the status of anemia of women. The determining variables were type of residence, age group, religion and castes, educational status, marital status, and household standard of living index. Anemia was most prevalent in the east zone for both the periods. The changes at the all India level were not much, but the north-east zone improved very well, whereas the south zone deteriorated drastically. The occurrence of severely anemic women in India varied between 1% and 2%. The highest prevalence rates were observed among women who were 15 to 24 years of age, illiterate, from non-Christian scheduled tribes (STs), unmarried, and whose standard of living was low. Rates of anemia have increased over time except in the case of Buddhists, Parsees, Jains, and the STs. From the viewpoint of our study, illiteracy and low standard of living may be the main causes of anemia among women in India. It is also necessary to take appropriate steps to curb anemia in women in their early adulthood. © 2012 APJPH.

Study on validity of a rapid diagnostic test kit versus light microscopy for malaria diagnosis in Ahmedabad city, India.

PubMed

Vyas, S; Puwar, B; Patel, V; Bhatt, G; Kulkarni, S; Fancy, M

2014-05-01

Light microscopy of blood smears for diagnosis of malaria in the field has several limitations, notably delays in diagnosis. This study in Ahmedabad in Gujarat State, India, evaluated the diagnostic performance of a rapid diagnostic test for malaria (SD Bioline Malaria Ag P.f/Pan) versus blood smear examination as the gold standard. All fever cases presenting at 13 urban health centres were subjected to rapid diagnostic testing and thick and thin blood smears. A total of 677 cases with fever were examined; 135 (20.0%) tested positive by rapid diagnostic test and 86 (12.7%) by blood smear. The sensitivity of the rapid diagnostic test for malaria was 98.8%, specificity was 91.5%, positive predictive value 63.0% and negative predictive value 99.8%. For detection of Plasmodium falciparum the sensitivity of rapid diagnostic test was 100% and specificity was 97.3%. The results show the acceptability of the rapid test as an alternative to light microscopy in the field setting.

Livelihood opportunities amongst adults with and without disabilities in Cameroon and India: A case control study

PubMed Central

Banks, Lena Morgon; Kuper, Hannah; Murthy, G. V. S.; Sagar, Jayanthi; Oye, Joseph; Polack, Sarah

2018-01-01

Proven links between disability and poverty suggest that development programmes and policies that are not disability-inclusive will leave persons with disabilities behind. Despite this, there is limited quantitative evidence on livelihood opportunities amongst adults with disabilities in Low and Middle Income Countries. This study adds to the limited evidence base, contributing data from one African and one Asian Setting. We undertook a population-based case–control study of adults (18+) with and without disabilities in North-West Cameroon and in Telangana State, India. We found that adults with disabilities were five times less likely to be working compared to age-sex matched controls in both settings. Amongst adults with disabilities, current age, marital status and disability type were key predictors of working. Inclusive programmes are therefore needed to provide adequate opportunities to participate in livelihood prospects for adults with disabilities in Cameroon and India, on an equal basis as others. These findings are of crucial importance at this stage of the Sustainable Development Agenda, to ensure that the mandate of inclusive development is achieved. PMID:29630606

Exploring the relationship between development and road traffic injuries: a case study from India.

PubMed

Garg, Nitin; Hyder, Adnan A

2006-10-01

Road traffic injuries (RTI) are a major cause of mortality and disability in the world. Only after significant losses have communities in developed nations taken necessary steps to prevent crashes and their consequences. Increase in road safety is related to increasing socio-economic development. We aim to study the trends in injury and death rates in a developing country, India, define sub-national variations, and analyse these trends in relation to economic and population growth. Public sector data from India were used to develop a standardized database on traffic injuries and indicator of economic development. The data were analysed using linear regression models to test the a priori hypothesis of a positive relationship between net domestic product (NDP), and injury and death rates from road crashes across states. The absolute burden of RTI in India has been consistently rising over the past three decades. The reported rates are lower than those estimated by global health agencies and may reflect under-reporting. Population-based rates provide a better assessment of the public health burden of RTI than vehicle-based rates. There is an inverted U-shaped relationship between NDP and injury and death rates. Even with the limited data, Kuznets phenomenon is evident for within-country level comparisons. India and other developing countries could learn from the experience of highly motorized nations to avoid the expected rise in RTI and deaths with economic development, by currently investing in road safety and prevention measures.

Incidence of Burkholderia mallei infection among indigenous equines in India.

PubMed

Malik, Praveen; Singha, Harisankar; Goyal, Sachin K; Khurana, Sandip K; Tripathi, Badri Naryan; Dutt, Abha; Singh, Dabal; Sharma, Neeraj; Jain, Sanjay

2015-01-01

Burkholderia mallei is the causative agent of glanders which is a highly contagious and fatal disease of equines. Considering the nature and severity of the disease in equines, and potential of transmission to human beings, glanders is recognised as a 'notifiable' disease in many countries. An increasing number of glanders outbreaks throughout the Asian continents, including India, have been noticed recently. In view of the recent re-emergence of the disease, the present study was undertaken to estimate the prevalence of glanders among indigenous equines from different parts of India. Serum samples were analysed by complement fixation test (CFT) and ELISA for the detection of B mallei specific antibodies. A total of 7794 equines, which included 4720 horses, 1881 donkeys and 1193 mules were sampled from April 2011 to December 2014 from 10 states of India. Serologically, 36 equines (pony=7, mules=10, horses=19) were found to be positive for glanders by CFT and indirect-ELISA. The highest number of cases were detected in Uttar Pradesh (n=31) followed by Himachal Pradesh (n=4) and Chhattisgarh (n=1). Isolation of B mallei was attempted from nasal and abscess swabs collected from seropositive equines. Four isolates of B mallei were cultured from nasal swabs of two mules and two ponies. Identity of the isolates was confirmed by PCR and sequencing of fliP gene fragment. The study revealed circulation of B mallei in northern India and the need for continued surveillance to support the eradication.

Incidence of Burkholderia mallei infection among indigenous equines in India

PubMed Central

Malik, Praveen; Singha, Harisankar; Goyal, Sachin K; Khurana, Sandip K; Tripathi, Badri Naryan; Dutt, Abha; Singh, Dabal; Sharma, Neeraj; Jain, Sanjay

2015-01-01

Burkholderia mallei is the causative agent of glanders which is a highly contagious and fatal disease of equines. Considering the nature and severity of the disease in equines, and potential of transmission to human beings, glanders is recognised as a ‘notifiable’ disease in many countries. An increasing number of glanders outbreaks throughout the Asian continents, including India, have been noticed recently. In view of the recent re-emergence of the disease, the present study was undertaken to estimate the prevalence of glanders among indigenous equines from different parts of India. Serum samples were analysed by complement fixation test (CFT) and ELISA for the detection of B mallei specific antibodies. A total of 7794 equines, which included 4720 horses, 1881 donkeys and 1193 mules were sampled from April 2011 to December 2014 from 10 states of India. Serologically, 36 equines (pony=7, mules=10, horses=19) were found to be positive for glanders by CFT and indirect-ELISA. The highest number of cases were detected in Uttar Pradesh (n=31) followed by Himachal Pradesh (n=4) and Chhattisgarh (n=1). Isolation of B mallei was attempted from nasal and abscess swabs collected from seropositive equines. Four isolates of B mallei were cultured from nasal swabs of two mules and two ponies. Identity of the isolates was confirmed by PCR and sequencing of fliP gene fragment. The study revealed circulation of B mallei in northern India and the need for continued surveillance to support the eradication. PMID:26457190

Bilateral periorbital necrotizing fasciitis following exposure to Holi colors: A case report

PubMed Central

Arora, Ritu; Das, Sima; Shroff, Daraius; Narula, Ritesh

2007-01-01

Holi festival is celebrated in India traditionally by applying colors on one another. Various ocular adverse effects of these colors have been reported including conjunctivitis and corneal abrasion. We report a case of bilateral periorbital necrotizing fasciitis, following exposure to Holi colors. General physicians might encounter more such cases after exposure to Holi colors. In India, these colors are prepared on a small scale and lack any quality checks. Use of such toxic colors should be discouraged, and all doctors should caution people against using synthetic dyes. This case report highlights the need to put manufacturing of Holi colors under guidelines of the Food and Drug Cosmetic Act and the Bureau of Indian Standards. PMID:17699947

Comprehensive genomic analysis identifies pathogenic variants in maturity-onset diabetes of the young (MODY) patients in South India.

PubMed

Mohan, Viswanathan; Radha, Venkatesan; Nguyen, Thong T; Stawiski, Eric W; Pahuja, Kanika Bajaj; Goldstein, Leonard D; Tom, Jennifer; Anjana, Ranjit Mohan; Kong-Beltran, Monica; Bhangale, Tushar; Jahnavi, Suresh; Chandni, Radhakrishnan; Gayathri, Vijay; George, Paul; Zhang, Na; Murugan, Sakthivel; Phalke, Sameer; Chaudhuri, Subhra; Gupta, Ravi; Zhang, Jingli; Santhosh, Sam; Stinson, Jeremy; Modrusan, Zora; Ramprasad, V L; Seshagiri, Somasekar; Peterson, Andrew S

2018-02-13

Maturity-onset diabetes of the young (MODY) is an early-onset, autosomal dominant form of non-insulin dependent diabetes. Genetic diagnosis of MODY can transform patient management. Earlier data on the genetic predisposition to MODY have come primarily from familial studies in populations of European origin. In this study, we carried out a comprehensive genomic analysis of 289 individuals from India that included 152 clinically diagnosed MODY cases to identify variants in known MODY genes. Further, we have analyzed exome data to identify putative MODY relevant variants in genes previously not implicated in MODY. Functional validation of MODY relevant variants was also performed. We found MODY 3 (HNF1A; 7.2%) to be most frequently mutated followed by MODY 12 (ABCC8; 3.3%). They together account for ~ 11% of the cases. In addition to known MODY genes, we report the identification of variants in RFX6, WFS1, AKT2, NKX6-1 that may contribute to development of MODY. Functional assessment of the NKX6-1 variants showed that they are functionally impaired. Our findings showed HNF1A and ABCC8 to be the most frequently mutated MODY genes in south India. Further we provide evidence for additional MODY relevant genes, such as NKX6-1, and these require further validation.

Inequalities in advice provided by public health workers to women during antenatal sessions in rural India.

PubMed

Singh, Abhishek; Pallikadavath, Saseendran; Ram, Faujdar; Ogollah, Reuben

2012-01-01

Studies have widely documented the socioeconomic inequalities in maternal and child health related outcomes in developing countries including India. However, there is limited research on the inequalities in advice provided by public health workers on maternal and child health during antenatal visits. This paper investigates the inequalities in advice provided by public health workers to women during antenatal visits in rural India. The District Level Household Survey (2007-08) was used to compute rich-poor ratios and concentration indices. Binary logistic regressions were used to investigate inequalities in advice provided by public health workers. The dependent variables comprised the advice provided on seven essential components of maternal and child health care. A significant proportion of pregnant women who attended at least four ANC sessions were not advised on these components during their antenatal sessions. Only 51%-72% of the pregnant women were advised on at least one of the components. Moreover, socioeconomic inequalities in providing advice were significant and the provision of advice concentrated disproportionately among the rich. Inequalities were highest in the case of advice on family planning methods. Advice on breastfeeding was least unequal. Public health workers working in lower level health facilities were significantly less likely than their counterparts in the higher level health facilities to provide specific advice. A significant proportion of women were not advised on recommended components of maternal and child health in rural India. Moreover, there were enormous socioeconomic inequalities. The findings of this study raise questions about the capacity of the public health care system in providing equitable services in India. The Government of India must focus on training and capacity building of the public health workers in communication skills so that they can deliver appropriate and recommended advice to all clients, irrespective of their socioeconomic status.

Prevalence of the β(S) gene among scheduled castes, scheduled tribes and other backward class groups in Central India.

PubMed

Shrikhande, Anuradha V; Arjunan, Aishwarya; Agarwal, Amit; Dani, Aarti; Tijare, Jayashri; Gettig, Elizabeth; Krishnamurti, Lakshmanan

2014-01-01

Sickle cell disease is an inherited disorder of the blood, and characterized by vasoocclusive crises (VOC), risks for pneumococcal infections and organ toxicities, is associated with morbidity and premature mortality. India, with a population of 1.2 billion individuals, is estimated to be home to over 50.0% of the world's patients with sickle cell disease. The β(S) gene [β6(A3)Glu→Val; HBB: c.20A>T] has the highest prevalence in three socio-economically disadvantaged ethnic categories: the Scheduled Castes (SC), the Scheduled Tribes (ST), and Other Backward Class (OBC) groups in India. The tradition of endogamy practiced by the ethnic groups in India provides the rationale for the screening of individual populations to better understand the distribution of the β(S) gene, guide counseling and awareness programs and aid development of public policy. We undertook a study to describe the prevalence of the β(S) gene in these ethnic groups in the district of Nagpur, Maharashtra in Central India. Through community screening and subsequent targeted screening of high risk individuals, 35,636 individuals were screened, of whom 5466 were found to have sickle cell trait and 1010 were identified with sickle cell disease. Community screening revealed a sickle cell trait prevalence of 13.0% in the SC, 12.0% in the ST and 3.4% in the OBC population. This study describes the prevalence of the β(S) gene within these groups in Central India determined by large scale community screening. This program has uncovered previously undiagnosed cases, provided detailed information to guide population-based disease counseling, prevention and comprehensive care programs.

A Case of Problematic Diffusion: The Use of Sex Determination Techniques in India.

ERIC Educational Resources Information Center

Luthra, Rashmi

1994-01-01

Discussion of model shifts in diffusion research focuses on the growth in the use of sex determination techniques in India and their consequences relating to gender and power. Topics addressed include development, underdevelopment, and modernization; the adoption of innovations; and meanings of innovations within particular social systems.…

Establishing a Commercial Buildings Energy Data Framework for India: A Comprehensive Look at Data Collection Approaches, Use Cases and Institutions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Iyer, Maithili; Kumar, Satish; Mathew, Sangeeta

Enhancing energy efficiency of the commercial building stock is an important aspect of any national energy policy. Understanding how buildings use energy is critical to formulating any new policy that may impact energy use, underscoring the importance of credible data. Data enables informed decision making and good quality data is essential for policy makers to prioritize energy saving strategies and track implementation. Given the uniqueness of the buildings sector and challenges to collecting relevant energy data, this study characterizes various elements involved in pertinent data collection and management, with the specific focus on well-defined data requirements, appropriate methodologies and processes,more » feasible data collection mechanisms, and approaches to institutionalizing the collection process. This report starts with a comprehensive review of available examples of energy data collection frameworks for buildings across different countries. The review covers the U.S. experience in the commercial buildings sector, the European experience in the buildings sector and other data collection initiatives in Singapore and China to capture the more systematic efforts in Asia in the commercial sector. To provide context, the review includes a summary and status of disparate efforts in India to collect and use commercial building energy data. Using this review as a key input, the study developed a data collection framework for India with specific consideration to relevant use cases. Continuing with the framework for data collection, this study outlines the key performance indicators applicable to the use cases and their collection feasibility, as well as immediate priorities of the participating stakeholders. It also discusses potential considerations for data collection and the possible approaches for survey design. With the specific purpose of laying out the possible ways to structure and organize data collection institutionally, the study collates existing mechanisms to analyze building energy performance in India and opportunities for standardizing data collection. This report describes the existing capacities and resources for establishing an institutional framework for data collection, the legislation and mandates that support such activity, and identifies roles and responsibilities of the relevant ministries and organizations. Finally, the study presents conclusions and identifies two major data collection strategies within the existing legal framework.« less

Epidemiological correlates of cataract cases in tertiary health care center in rural area of maharashtra.

PubMed

Avachat, Shubhada Sunil; Phalke, Vaishali; Kambale, Suchit

2014-01-01

The most recent estimates from World Health Organization (WHO) reveal that 47.8% of global blindness is due to cataract. Cataract has been documented to be the most significant cause of bilateral blindness in India. The most recent estimates from WHO reveal that 47.8% of global blindness is due to cataract and in south Asia region which includes India, 51% of blindness is due to cataract. In India cataract is the principal cause of blindness accounting for 62.6% cases of blindness. The key to the success of the Global Vision 2020: The right to sight initiative is a special effort to tackle cataract blindness which includes estimation of magnitude of the problem and understanding factors associated with it. Therefore, a study was conducted in the hospital to estimate the magnitude of cataract and study various epidemiological factors associated with it. A cross-sectional study was conducted in a tertiary health center in rural area. Total 746 patients who availed services from ophthalmology department during study period were included in the study and relevant data was collected from them. Data analysis was done by percentages, proportions, and tests of significance (Chi-square test). Out of 746 patients, 400 (53.6%) were suffering from cataract. Senile cataract was the most common cause (54%). Fifty-five percent patients were in the age group of 60-80 years and majority of them were from low socioeconomic strata. The prevalence of cataract in a medical college hospital in rural area was 53.6%. Age, sex, and educational status were significantly associated with cataract.

The Global Mental Health movement and its impact on traditional healing in India: A case study of the Balaji temple in Rajasthan.

PubMed

Sood, Anubha

2016-12-01

This article considers the impact of the global mental health discourse on India's traditional healing systems. Folk mental health traditions, based in religious lifeways and etiologies of supernatural affliction, are overwhelmingly sought by Indians in times of mental ill-health. This is despite the fact that the postcolonial Indian state has historically considered the popularity of these indigenous treatments regressive, and claimed Western psychiatry as the only mental health system befitting the country's aspirations as a modern nation-state. In the last decade however, as global mental health concerns for scaling up psychiatric interventions and instituting bioethical practices in mental health services begin to shape India's mental health policy formulations, the state's disapproving stance towards traditional healing has turned to vehement condemnation. In present-day India, traditional treatments are denounced for being antithetical to global mental health tenets and harmful for the population, while biomedical psychiatry is espoused as the only legitimate form of mental health care. Based on ethnographic research in the Hindu healing temple of Balaji, Rajasthan, and analysis of India's mental health policy environment, I demonstrate how the tenor of the global mental health agenda is negatively impacting the functioning of the country's traditional healing sites. I argue that crucial changes in the therapeutic culture of the Balaji temple, including the disappearance of a number of key healing rituals, are consequences of global mental health-inspired policy in India which is reducing the plural mental health landscape.

Does iodine excess lead to hypothyroidism? Evidence from a case-control study in India.

PubMed

Kotwal, Atul; Kotwal, Jyoti; Prakash, Rajat; Kotwal, Narendra

2015-08-01

Iodine deficiency disorders have been known to mankind since antiquity and various researchers elucidated the role of iodine in its causation. However, recent evidence shows that the entire control program ignored multi-causality and association of increased iodine intake with hypothyroidism. This study was conducted to assess differences of iodine intake as measured by urinary iodine excretion (UIE) between cases of hypothyroidism and healthy controls. A case-control study was conducted with three groups (cases, hospital controls and community controls) in two cities of India. Patients with overt hypothyroidism were cases (n = 150) and were compared with age, sex and socioeconomic status-matched hospital (n = 154) and community (n = 488) controls. Thyroid function tests (T3, T4, TSH) were used as diagnostic and inclusion criteria. TPOAb and UIE estimation were carried out for all study participants. Mean values of TPOAb and UIE were higher in cases as compared to hospital controls as well as community controls (p <0.05). With a cut off of 34 IU/mL for TPOAb, more cases had an anti-TPO level >34 as compared to hospital controls (p <0.001) as well as community controls (p <0.001); OR, 0.06 (95% CI, 0.03, 0.12) and 0.08 (0.05, 0.12), respectively. For UIE cut-off of 300 μg/L, more cases than hospital controls (p = 0.090) and community controls (p = 0.001) had higher levels; OR, 0.671, (0.422, 1.066) and 0.509, (0.348, 0.744), respectively. The study has clearly shown that cases of hypothyroidism are associated with excess iodine intake. Cohort studies to generate further evidence and an eco-social epidemiological approach have been suggested as the way forward. Copyright © 2015 IMSS. Published by Elsevier Inc. All rights reserved.

Critical analysis of vector-borne infections in dogs: Babesia vogeli, Babesia gibsoni, Ehrlichia canis and Hepatozoon canis in Punjab, India.

PubMed

Singla, Lachhman Das; Sumbria, Deepak; Mandhotra, Ajay; Bal, M S; Kaur, Paramjit

2016-12-01

There are few published studies on various vector borne diseases of dogs in India and most depict clinical infection in dogs, diagnosed by observation of the haemopathogens in stained blood smears. This study provides the first report regarding molecular confirmation and ancestral relationship analysis of blood smears positive cases of assorted haemopathogens in Punjab province of India. On blood smear examination, haemopathogens were observed in 124 out of 778 (15.95%, 95% CI: 13.53- 18.68) blood smears. Further polymerase chain reactions (PCR) was used on bloods smear positive cases to validate the results. Out of 778 blood samples, Babesia gibsoni was most common parasite infecting dogs (15.04%, 95% CI: 12.7-17.72), followed by Ehrlichia canis (0.39%, 95% CI: 0.0-1.13), infection of Babesia vogeli and Hepatozoon canis was same (0.26%, 95% CI: 0.0-0.9). Among various risk factors studied (age, sex, season), prevalence of infection was non-significantly higher in 1-2 year of age group (19.88%, 95% CI: 14.45-26.71), regarding sex same prevalence was recorded (15.94%), and chances of infection was highest in pre-monsoon i.e. summer (18.26%, 95% CI: 14.49-22.76). Phylogenetic analysis revealed ancestral background of Ludhiana isolates of B. vogeli, B. gibsoni, H. canis, and E. canis with the isolates of Philippines, Mongolia and Tunisia.

White grain mycetoma caused by Scedosporium apiospermum in North India: a case report.

PubMed

Gupta, Munesh Kumar; Banerjee, Tuhina; Kumar, Dhirendra; Rastogi, Amit; Tilak, Ragini

2013-12-01

Mycetoma is chronic granulomatous infection of skin and subcutaneous tissue caused by both bacteria and fungi. We report a case of mycetoma caused by Scedosporium apiospermum in the right foot of a 45-year-old farmer in north India. The patient had a history of trauma in the sole of the right foot followed by discharge of white granules along with proximal progression. Scedosporium apiospermum was identified based on colony characteristics and microscopic features on slide culture. Mycetoma is a progressive disease. Foot is commonly affected in persons who walk barefoot, especially in south India. Untreated mycetoma progress and involve the underlying fasciae and tissues along with bones often resulting in loss of limb. By prompt and reliable diagnosis with corresponding antimicrobial administration, we can prevent further progression and limb disability.

Quantifying the Impacts of Large Scale Integration of Renewables in Indian Power Sector

NASA Astrophysics Data System (ADS)

Kumar, P.; Mishra, T.; Banerjee, R.

2017-12-01

India's power sector is responsible for nearly 37 percent of India's greenhouse gas emissions. For a fast emerging economy like India whose population and energy consumption are poised to rise rapidly in the coming decades, renewable energy can play a vital role in decarbonizing power sector. In this context, India has targeted 33-35 percent emission intensity reduction (with respect to 2005 levels) along with large scale renewable energy targets (100GW solar, 60GW wind, and 10GW biomass energy by 2022) in INDCs submitted at Paris agreement. But large scale integration of renewable energy is a complex process which faces a number of problems like capital intensiveness, matching intermittent loads with least storage capacity and reliability. In this context, this study attempts to assess the technical feasibility of integrating renewables into Indian electricity mix by 2022 and analyze its implications on power sector operations. This study uses TIMES, a bottom up energy optimization model with unit commitment and dispatch features. We model coal and gas fired units discretely with region-wise representation of wind and solar resources. The dispatch features are used for operational analysis of power plant units under ramp rate and minimum generation constraints. The study analyzes India's electricity sector transition for the year 2022 with three scenarios. The base case scenario (no RE addition) along with INDC scenario (with 100GW solar, 60GW wind, 10GW biomass) and low RE scenario (50GW solar, 30GW wind) have been created to analyze the implications of large scale integration of variable renewable energy. The results provide us insights on trade-offs involved in achieving mitigation targets and investment decisions involved. The study also examines operational reliability and flexibility requirements of the system for integrating renewables.

Can the management of blood sugar levels in gestational diabetes mellitus cases be an indicator of maternal and fetal outcomes? The results of a prospective cohort study from India

PubMed Central

Jain, Rajesh; Davey, Sanjeev; Davey, Anuradha; Raghav, Santosh K.; Singh, Jai V.

2016-01-01

Background: Gestational diabetes mellitus (GDM) is emerging as an important public health problem in India owing to its increasing prevalence since the last decade. The issue addressed in the study was whether the management of blood sugar levels in GDM cases can predict maternal and fetal outcomes. Materials and Methods: A prospective cohort study was done for 1 year from October 1, 2013, to September 31, 2014, at 652 diabetic screening units as a part of the Gestational Diabetes Prevention and Control Project approved by the Indian Government in the district of Kanpur, state of Uttar Pradesh. A total of 57,108 pregnant women were screened during their 24–28th weeks of pregnancy by impaired oral glucose test. All types of maternal and perinatal outcomes were followed up in both GDM and non-GDM categories in the 2nd year (2013–2014) after blood sugar levels were controlled. Results: It was seen that for all kinds of maternal and fetal outcomes, the differences between GDM cases and non-GDM cases were highly significant (P < 0.0001, relative risk >1 in every case). Moreover, perinatal mortality also increased significantly from 5.7% to 8.9% when blood sugar levels increased from 199 mg/dl and above. Perinatal and maternal outcomes in GDM cases were also significantly related to the control of blood sugar levels (P < 0.0001). Conclusion: Blood sugar levels can be an indicator of maternal and perinatal morbidity and mortality in GDM cases, provided unified diagnostic criteria are used by Indian laboratories. However, to get an accurate picture on this issue, all factors need further study. PMID:27186155

India Renewable Integration Study | Energy Analysis | NREL

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India Renewable Integration Study India Renewable Integration Study An NREL grid integration study Energy into India's Electric Grid Vol. I-National Study and Vol. II-Regional Study resolves many system modeling, the study explored operational impacts of meeting India's 2022 targets and identified

Significance of blood group and social factors in carcinoma cervix in a semi-urban population in India.

PubMed

Kai, Lee Jun; Raju, Kalyani; Malligere Lingaiah, Harendra Kumar; Mariyappa, Narayanaswamy

2013-01-01

To assess the significance of social factors as risk factors for carcinoma cervix and to determine the significance of blood group to prevalence of carcinoma cervix in a semi-urban population of Kolar, Karnataka, India. One hundred cases of carcinoma cervix were included in the study, along with 200 females of the same ages considered as controls. Case details were collected from the hospital record section regarding social factors and blood groups and the data were analyzed by descriptive statistical methods. Blood group B showed the highest number of cases (55 cases) followed by blood group O (29 cases) in carcinoma cervix which was statistically significant (p<0.001). Age of marriage between 11 to 20 years showed highest number of carcinoma cervix cases (77 cases) and this also was statistically significant (p<0.001). Patients with rural background were 75 (p=0.112, odds ratio: 1.54), parity of more than or equal to two constituted 96 cases (p=0.006, odds ratio: 4.07) and Hindu patients were 95 in number (p=0.220, odds ratio: 1.89). Blood group B and age of marriage between 11 and 20 years were significantly associated with carcinoma cervix in our population. Region of residence, parity and religion presented with a altered risk for carcinoma cervix.

The Drop-Out Problem in Primary Education: Towards Universalization of Primary Education in Asia and the Pacific--Some Case Studies: China, India, Peninsular Malaysia, Socialist Republic of Viet Nam, Sri Lanka, and Thailand.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Regional Office for Education in Asia and the Pacific.

The ways in which six developing countries in Asia are dealing with the problem of children dropping out of elementary school are discussed in these essays. One of the persistent problems that has deterred universalization of primary education is the early dropping out of children from schools. Case studies describing the magnitude and causes of…

Compliance with infection control practices in sputum microscopy centres: a study from Kerala, India

PubMed Central

Ubaid, N. P.; Nagaraja, S. B.; Shewade, H. D.; Padmanabhan, K. V.; Naik, B. R.; Satpati, M.; Blesson, S.; Jayasree, A. K.

2015-01-01

Background: One of the strategies of the Revised National Tuberculosis Control Programme in India to achieve tuberculosis control is by increasing case detection through a nationwide network of designated microscopy centres (DMC). Practice of standard precautions for infection control in these DMCs is very important to prevent transmission of infection not only to the laboratory personnel, but also to the general population. However, in India this has not been evaluated by an external agency. Method: A cross-sectional study was carried out to assess knowledge, facilities and compliance regarding infection control practices (ICP) in all 38 DMCs in Kannur district, Kerala, India, in 2015. Using observations and interviews, the investigators collected data in a structured format. Results: Overall knowledge about infection control was found to be satisfactory among 29% of laboratory technicians. Overall facilities for infection control were satisfactory in 61% of the DMCs, while adherence to ICP was satisfactory in 45% of the DMCs. Knowledge regarding ICP was better in government DMCs, whereas facilities for ICP and adherence to biomedical waste management guidelines were better in private DMCs. Conclusion: Given the higher risk of infection among laboratory technicians, there is an urgent need to address the shortcomings in infection control practices. PMID:26767180

Innovations 'Out of Place': Controversies Over IVF Beginnings in India Between 1978 and 2005.

PubMed

Bärnreuther, Sandra

2016-01-01

In 1978, the year the first in vitro fertilization (IVF) baby was born in the United Kingdom, a research team in Kolkata reported that it too had successfully produced an IVF baby in India. However, the claim was dismissed at the time, because the experiment was conducted outside authorized institutions and recognized centers of innovation--in short, because it was an innovation 'out of place.' Tracing controversies over the case between 1978 and 2005, I show the importance of space or place in processes of knowledge production and recognition. Further, I explain the initial repudiation and subsequent partial recognition of the claim through shifts in the landscape of legitimate spaces of innovation. By discussing this specific case of the production of science and technology in the Global South, I challenge conventional narratives of diffusion that are prevalent in studies on the worldwide proliferation of reproductive technologies.

Assessment of PM2.5 concentrations on Human Health: A case study of Delhi, India

NASA Astrophysics Data System (ADS)

Goyal, P.; Mishra, D.

2015-12-01

Connection of air quality with human health is well established in the literature. However the associated health risks due to fine particulate matter (PM2.5) concentration is not well known in India, while the assigned mean threshold values are 60 μg/m3 for 24-hour period and 40 μg/m3 for annual period. Both are considered safe concentration limits regarding human health effects. However, the daily and annually concentrations of PM2.5 were observed more than three times of NAAQS in the present study for a year. This study relates the incessant exposure to significant levels of PM2.5 to deleterious health effects, such as heart and lung diseases. The relation between environmental air quality and human health has been studied through different parameters e.g., hazard quotient (HQ), lifetime incremental cancer risk (LICR), and individual risk for different groups of ages in Delhi, the capital city of India. These analysis lead to additional insights into health disparities and may suggest that more rigorous strategies. This may be application to other urban areas across the nation. In this study, we propose to quantify such impacts through estimation of different health risk factors.

Malaria diagnosis by PCR revealed differential distribution of mono and mixed species infections by Plasmodium falciparum and P. vivax in India

PubMed Central

Dash, Manoswini; Kar, Sonalika; Rani, Swati; Rawal, Charu; Singh, Rajkumar; Anvikar, Anupkumar R.; Pande, Veena

2018-01-01

Malaria is a vector-borne infectious disease, caused by five different species of the genus Plasmodium, and is endemic to many tropical and sub-tropical countries of the globe. At present, malaria diagnosis at the primary health care level in India is conducted by either microscopy or rapid diagnostic test (RDT). In recent years, molecular diagnosis (by PCR assay), has emerged as the most sensitive method for malaria diagnosis. India is highly endemic to malaria and shoulders the burden of two major malaria parasites, Plasmodium falciparum and P. vivax. Previous studies using PCR diagnostic assay had unraveled several interesting facts on distribution of malaria parasites in India. However, these studies had several limitations from small sample size to limited geographical areas of sampling. In order to mitigate these limitations, we have collected finger-prick blood samples from 2,333 malaria symptomatic individuals in nine states from 11 geographic locations, covering almost the entire malaria endemic regions of India and performed all the three diagnostic tests (microscopy, RDT and PCR assay) and also have conducted comparative assessment on the performance of the three diagnostic tests. Since PCR assay turned out to be highly sensitive (827 malaria positive cases) among the three types of tests, we have utilized data from PCR diagnostic assay for analyses and inferences. The results indicate varied distributional prevalence of P. vivax and P. falciparum according to locations in India, and also the mixed species infection due to these two species. The proportion of P. falciparum to P. vivax was found to be 49:51, and percentage of mixed species infections due to these two parasites was found to be 13% of total infections. Considering India is set for malaria elimination by 2030, the present malaria epidemiological information is of high importance. PMID:29565981

Malaria diagnosis by PCR revealed differential distribution of mono and mixed species infections by Plasmodium falciparum and P. vivax in India.

PubMed

Siwal, Nisha; Singh, Upasana Shyamsunder; Dash, Manoswini; Kar, Sonalika; Rani, Swati; Rawal, Charu; Singh, Rajkumar; Anvikar, Anupkumar R; Pande, Veena; Das, Aparup

2018-01-01

Malaria is a vector-borne infectious disease, caused by five different species of the genus Plasmodium, and is endemic to many tropical and sub-tropical countries of the globe. At present, malaria diagnosis at the primary health care level in India is conducted by either microscopy or rapid diagnostic test (RDT). In recent years, molecular diagnosis (by PCR assay), has emerged as the most sensitive method for malaria diagnosis. India is highly endemic to malaria and shoulders the burden of two major malaria parasites, Plasmodium falciparum and P. vivax. Previous studies using PCR diagnostic assay had unraveled several interesting facts on distribution of malaria parasites in India. However, these studies had several limitations from small sample size to limited geographical areas of sampling. In order to mitigate these limitations, we have collected finger-prick blood samples from 2,333 malaria symptomatic individuals in nine states from 11 geographic locations, covering almost the entire malaria endemic regions of India and performed all the three diagnostic tests (microscopy, RDT and PCR assay) and also have conducted comparative assessment on the performance of the three diagnostic tests. Since PCR assay turned out to be highly sensitive (827 malaria positive cases) among the three types of tests, we have utilized data from PCR diagnostic assay for analyses and inferences. The results indicate varied distributional prevalence of P. vivax and P. falciparum according to locations in India, and also the mixed species infection due to these two species. The proportion of P. falciparum to P. vivax was found to be 49:51, and percentage of mixed species infections due to these two parasites was found to be 13% of total infections. Considering India is set for malaria elimination by 2030, the present malaria epidemiological information is of high importance.

Dioctophymatosis renalis in humans: first case report from India.

PubMed

Venkatrajaiah, N; Kalbande, Sanjay H; Rao, G Vamshi Nandan; Reddy, V Chenna; Reddy, S Hiran; Rao, P Ragini; Babu, Kartheek; Keerthi, A

2014-10-01

Dioctophymatosis is an infestation by Dioctophyma renalis (the giant kidney worm), a relatively uncommon parasitic roundworm that infects carnivorous mammals. Since the early 1900s, dioctophymatosis has been confirmed in < 20 humans worldwide. A 70-year-old man attended our Hospital, complaining of having expelled 2 large worms while urination along with haematuria 2 days post-admission. On MR UROGRAM we confirmed it as dioctophyma renale.wet mount preparation of urine under microscopy showed eggs specific for the parasite. On review of literature we found that this was the first case reported in india.

Health and economic benefits of scaling up a home-based neonatal care package in rural India: a modelling analysis.

PubMed

Nandi, Arindam; Colson, Abigail R; Verma, Amit; Megiddo, Itamar; Ashok, Ashvin; Laxminarayan, Ramanan

2016-06-01

Approximately 900 000 newborn children die every year in India, accounting for 28% of neonatal deaths globally. In 2011, India introduced a home-based newborn care (HBNC) package to be delivered by community health workers across rural areas. We estimate the disease and economic burden that could be averted by scaling up the HBNC in rural India using IndiaSim, an agent-based simulation model, to examine two interventions. In the first intervention, the existing community health worker network begins providing HBNC for rural households without access to home- or facility-based newborn care, as introduced by India's recent programme. In the second intervention, we consider increased coverage of HBNC across India so that total coverage of neonatal care (HBNC or otherwise) in the rural areas of each state reaches at least 90%. We find that compared with a baseline of no coverage, providing the care package through the existing network of community health workers could avert 48 [95% uncertainty range (UR) 34-63] incident cases of severe neonatal morbidity and 5 (95% UR 4-7) related deaths, save $4411 (95% UR $3088-$5735) in out-of-pocket treatment costs, and provide $285 (95% UR $200-$371) in value of insurance per 1000 live births in rural India. Increasing the coverage of HBNC to 90% will avert an additional 9 (95% UR 7-12) incident cases, 1 death (95% UR 0.72-1.33), and $613 (95% UR $430-$797) in out-of-pocket expenditures, and provide $55 (95% UR $39-$72) in incremental value of insurance per 1000 live births. Intervention benefits are greater for lower socioeconomic groups and in the poorer states of Chhattisgarh, Uttarakhand, Bihar, Assam and Uttar Pradesh. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Monsoon harvests: the living legacies of rainwater harvesting systems in South India.

PubMed

Van Meter, Kimberly J; Basu, Nandita B; Tate, Eric; Wyckoff, Joseph

2014-04-15

Rainwater harvesting, a "soft path" approach toward water management, is increasingly recognized as a key strategy toward ensuring food security and alleviating problems of water scarcity. Interestingly this "modern" approach has been in use for millennia in numerous older civilizations. This article uses India as a case study to explore the social, economic, and environmental dimensions of agricultural rainwater harvesting ponds, and evaluates the viability of these centuries-old systems under current climate and population pressures. A holistic watershed-scale approach that accounts for trade-offs in water availability and socioeconomic wellbeing is recommended for assessing the sustainability of these systems.

Aspects of legislative cognizance of noise pollution in India.

PubMed

Kumar, Brind; Oberoi, Sharad V

2011-04-01

The impacts of noise pollution are associated with the mental, physical, emotional and psychological well-being of an individual. Its damaging effects from various natural and man-made sources are potential hazards that need to be checked at the planning, executive and judicial levels. The paper presents an overview of the technological aspects of noise pollution, and seeks to visit its legislative aspects with respect to India. Excerpts from international laws are presented for a meaningful discussion. References are made from the conclusions of studies carried out by researchers and legislative cases involving noise pollution to make this paper useful for researchers, planners and administrators.

The Estimated Health and Economic Benefits of Three Decades of Polio Elimination Efforts in India.

PubMed

Nandi, Arindam; Barter, Devra M; Prinja, Shankar; John, T Jacob

2016-08-07

In March 2014, India, the country with historically the highest burden of polio, was declared polio free, with no reported cases since January 2011. We estimate the health and economic benefits of polio elimination in India with the oral polio vaccine (OPV) during 1982-2012. Based on a pre-vaccine incidence rate, we estimate the counterfactual burden of polio in the hypothetical absence of the national polio elimination program in India. We attribute differences in outcomes between the actual (adjusted for under-reporting) and hypothetical counterfactual scenarios in our model to the national polio program. We measure health benefits as averted polio incidence, deaths, and disability adjusted life years (DALYs). We consider two methods to measure economic benefits: the value of statistical life approach, and equating one DALY to the Gross National Income (GNI) per capita. We estimate that the National Program against Polio averted 3.94 million (95% confidence interval [CI]: 3.89-3.99 million) paralytic polio cases, 393,918 polio deaths (95% CI: 388,897- 398,939), and 1.48 billion DALYs (95% CI: 1.46-1.50 billion). We also estimate that the program contributed to a $1.71 trillion (INR 76.91 trillion) gain (95% CI: $1.69-$1.73 trillion [INR 75.93-77.89 trillion]) in economic productivity between 1982 and 2012 in our base case analysis. Using the GNI and DALY method, the economic gain from the program is estimated to be $1.11 trillion (INR 50.13 trillion) (95% CI: $1.10-$1.13 trillion [INR 49.50-50.76 trillion]) over the same period. India accrued large health and economic benefits from investing in polio elimination efforts. Other programs to control/eliminate more vaccine-preventable diseases are likely to contribute to large health and economic benefits in India.

XDR-TB: an outcome of programmatic management of TB in India.

PubMed

Mishra, Gyanshankar; Ghorpade, S V; Mulani, Jasmin

2014-01-01

A significantly strengthened Revised National Tuberculosis Control Programme (RNTCP) is currently operational in India. In this case-based commentary, we describe the plight of a patient who developed extensive drug-resistant tuberculosis (XDR-TB) despite having received treatment under the RNTCP for a long period. Our aim is to analyse the programmatic management of tuberculosis in India by highlighting and discussing various issues related to the treatment received by the patient. Further, the article explores whether there is a need to incorporate an ethical element into the RNTCP as it stands today.

Head and Neck Tuberculosis: Scenario in a Tertiary Care Hospital of North Eastern India

PubMed Central

Das, Debajit; Bhuyan, Uttal Taranga; Saikia, Nabajyoti

2016-01-01

Introduction Tuberculosis has affected mankind since time immemorial and with emergence of AIDS both extrapulmonary and pulmonary tuberculosis presents increased morbidity and mortality along with an increased financial burden upon the developing nations. Materials and Methods The study is a hospital based observational study of one year duration carried out in the Department of ENT in a tertiary care hospital of North Eastern India. Results Total of 63 cases were detected. Females comprised 60.3% of the study population as against 39.7% males. Most commonly affected age group were of 15 to 24 years age (57.1%). Cervical tubercular lymphadenitis was the most common lesion 90.5% (57 cases) followed by laryngeal tuberculosis 7.9% (5 cases) and tubercular otitis media with mastoiditis 1.6% (1 case). Level II lymph node was mostly affected either single or in groups (75.4%) followed by level III node (57.9%). Successful outcome of the treatment with Category I regimen was achieved in 96.8% of the cases. Conclusion Head and neck tuberculosis is not an uncommon disease and though cervical lymphadenitis is the most common presentation, isolated involvement of the larynx, ear and other subsites are not an entirely unknown entity. The clinical presentation of tuberculosis of the head and neck region can be varied and often misleading. It is therefore important for the clinician to be aware of the condition and consider it in their differential diagnosis. PMID:26894099

Pathways To Scaling-Up in Community Based Rehabilitation Agencies.

ERIC Educational Resources Information Center

Boyce, W.; Johnston, C.; Thomas, M.; Enns, H.; Naidu, D. M.; Tjandrakusuma, H.

1997-01-01

Scaling-up (the expansion or development of organizational activities of nongovernmental agencies to achieve greater impact) in community-based rehabilitation is described by using case study materials from industrialized and less-developed countries (India, Canada, and Indonesia) and focusing on differences in structural characteristics of…

Profile of inhalant users seeking treatment at a de-addiction centre in north India.

PubMed

Gupta, Sunil; Nebhinani, Naresh; Basu, Debasish; Mattoo, Surendra Kumar

2014-05-01

Inhalants are substances whose chemical vapors are inhaled to produce euphoric, disinhibiting, and exciting effects. Data on inhalant abuse in India are relatively scarce. We report the demographic and clinical profile of inhalant users among the treatment seekers at a Drug De-addiction and Treatment Centre in north India. The records of treatment seekers at the Drug De-addiction and Treatment Centre, over 10 years (2002-2011) were scanned to identify 92 cases reporting inhalant use. Of these 92 cases, the complete record files were available for 87 (94.6%) cases. These case files were reviewed and the relevant data were collected and analyzed. Over the study period of 10 years, the number of cases with inhalant abuse per year rose steadily to peak at 20 cases (4.08% of new cases) in 2006 and then stabilized at 1-3 per cent of new cases annually. Of the 87 cases studied, all were males with a mean age of 18.9±4.12 yr, mean education of 9.8±3.42 yr and mean family income of Rs. 7676±7343.15 (median: Rs. 5000). Majority of subjects were unmarried (89.7%), urban resident (79.3%), and from a nuclear family (78.2%). About half of the subjects were students (50.6%). The most common inhalant used was typewriter correction fluid (73.6%) followed by typewriter diluent fluid (19.5%) and glue (6.9%). The most common reason for initiation was curiosity. The mean age of onset of inhalant use was 16.3±4.22 yr. Most subjects fulfilled the criteria for inhalant dependence (85.1%). Psychiatric co-morbidity and the family history of substance dependence were present in 26.4 and 32.9 per cent subjects, respectively. Majority of the subjects reported drug related problems, occupation and finance being the worst affected. Interpretations & conclusions: Our results showed that the inhalant users were mostly urban youth belonging to middle socio-economic class families. The principal sources of inhalant abuse were the commonly available substances like typewriter correction fluids and majority of the subjects initiated it out of curiosity. Nearly three-fourth of the subjects used some other substance of abuse in addition, tobacco being the most common. In view of associated drug related problems, there is a need for strategies to prevent this emerging health care problem.

Introducing leprosy post-exposure prophylaxis into the health systems of India, Nepal and Indonesia: a case study.

PubMed

Tiwari, A; Mieras, L; Dhakal, K; Arif, M; Dandel, S; Richardus, J H

2017-09-29

Leprosy has a wide range of clinical and socio-economic consequences. India, Indonesia and Nepal contribute significantly to the global leprosy burden. After integration, the health systems are pivotal in leprosy service delivery. The Leprosy Post Exposure Prophylaxis (LPEP) program is ongoing to investigate the feasibility of providing single dose rifampicin (SDR) as post-exposure prophylaxis (PEP) to the contacts of leprosy cases in various health systems. We aim to compare national leprosy control programs, and adapted LPEP strategies in India, Nepal and Indonesia. The purpose is to establish a baseline of the health system's situation and document the subsequent adjustment of LPEP, which will provide the context for interpreting the LPEP results in future. The study followed the multiple-case study design with single units of analysis. The data collection methods were direct observation, in-depth interviews and desk review. The study was divided into two phases, i.e. review of national leprosy programs and description of the LPEP program. The comparative analysis was performed using the WHO health system frameworks (2007). In all countries leprosy services including contact tracing is integrated into the health systems. The LPEP program is fully integrated into the established national leprosy programs, with SDR and increased documentation, which need major additions to standard procedures. PEP administration was widely perceived as well manageable, but the additional LPEP data collection was reported to increase workload in the first year. The findings of our study led to the recommendation that field-based leprosy research programs should keep health systems in focus. The national leprosy programs are diverse in terms of organizational hierarchy, human resource quantity and capacity. We conclude that PEP can be integrated into different health systems without major structural and personal changes, but provisions are necessary for the additional monitoring requirements.

Study of Serum Total PSA and Free PSA as an Oncological Marker in Breast Tumour.

PubMed

Jahir, Elteza Tahjiba; Devi, Runi; Borthakur, Bibhuti Bhushan

2017-03-01

Breast Cancer (BC) cases are rising alarmingly all over the world and India is not an exception. This rising trend is due to an increased age at first child birth, decreased breast feeding, and the changing lifestyle mostly in urban India. With the advent of more sensitive methodologies and research works in this field, it has been suggested that Prostate Specific Antigen (PSA) plays an important role in the pathogenesis of breast cancer besides other established tumour markers. To study the molecular forms of PSA-total and free PSA in benign and malignant tumours and to analyse their association with the tumour burden. The present study was conducted in collaboration with Gauhati Medical College and Hospital and Dr B Borooah Cancer Institute, Guwahati, Assam, India. Women in the age group of 18-65 years with recently diagnosed tumour (benign/malignant) in the breast were included in the study. Women taking Oral Contraceptive Pill (OCP), hormone replacement therapy, with past/present history of gynaecological/other malignancy and chronic endocrine disease like diabetes, thyroid disorders were excluded. The case group comprised of 50 female subjects with newly diagnosed Benign Breast Disease (BBD) and 50 subjects with BC, while 50 age matched healthy females without any signs and symptoms of breast discomfort were included in the control group. Laboratory tests done were Serum Total PSA (TPSA), Free PSA (FPSA), Fasting Blood Glucose (FBS), serum urea, serum creatinine and fasting lipid profile. TPSA and FPSA was measured again in both the test groups after 10-14 days of surgery/therapy. A fall in postoperative value of total and free PSA in BC case group was noticed. In Grade I tumours the mean value of total PSA (1.813 ng/ml) and free PSA (1.149 ng/ml) were higher than those with Grade III tumours (TPSA-1.07 ng/ml and FPSA-1.002 ng/ml). Mean value of Fasting Blood Sugar (FBG), total cholesterol and Low Density Lipoprotein (LDL) in BC case group was higher than the control group. From the study, we can conclude PSA as a possible new marker for diagnosis and prognosis of BC.

Euthanasia: Global Scenario and Its Status in India.

PubMed

Shekhawat, Raghvendra Singh; Kanchan, Tanuj; Setia, Puneet; Atreya, Alok; Krishan, Kewal

2018-04-01

The legal and moral validity of euthanasia has been questioned in different situations. In India, the status of euthanasia is no different. It was the Aruna Ramachandra Shanbaug case that got significant public attention and led the Supreme Court of India to initiate detailed deliberations on the long ignored issue of euthanasia. Realising the importance of this issue and considering the ongoing and pending litigation before the different courts in this regard, the Ministry of Health and Family Welfare, Government of India issued a public notice on May 2016 that invited opinions from the citizens and the concerned stakeholders on the proposed draft bill entitled The Medical Treatment of Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill. Globally, only a few countries have legislation with discreet and unambiguous guidelines on euthanasia. The ongoing developments have raised a hope of India getting a discreet law on euthanasia in the future.

Risk Factors for Treatment Default among Re-Treatment Tuberculosis Patients in India, 2006

PubMed Central

Jha, Ugra Mohan; Satyanarayana, Srinath; Dewan, Puneet K.; Chadha, Sarabjit; Wares, Fraser; Sahu, Suvanand; Gupta, Devesh; Chauhan, L. S.

2010-01-01

Setting Under India's Revised National Tuberculosis Control Programme (RNTCP), >15% of previously-treated patients in the reported 2006 patient cohort defaulted from anti-tuberculosis treatment. Objective To assess the timing, characteristics, and risk factors for default amongst re-treatment TB patients. Methodology For this case-control study, in 90 randomly-selected programme units treatment records were abstracted from all 2006 defaulters from the RNTCP re-treatment regimen (cases), with one consecutively-selected non-defaulter per case. Patients who interrupted anti-tuberculosis treatment for >2 months were classified as defaulters. Results 1,141 defaulters and 1,189 non-defaulters were included. The median duration of treatment prior to default was 81 days (25%–75% interquartile range 44–117 days) and documented retrieval efforts after treatment interruption were inadequate. Defaulters were more likely to have been male (adjusted odds ratio [aOR] 1.4, 95% confidence interval [CI] 1.2–1.7), have previously defaulted anti-tuberculosis treatment (aOR 1.3 95%CI 1.1–1.6], have previous treatment from non-RNTCP providers (AOR 1.3, 95%CI 1.0–1.6], or have public health facility-based treatment observation (aOR 1.3, 95%CI 1.1–1.6). Conclusions Amongst the large number of re-treatment patients in India, default occurs early and often. Improved pre-treatment counseling and community-based treatment provision may reduce default rates. Efforts to retrieve treatment interrupters prior to default require strengthening. PMID:20111727

A literature review and update on the incidence and microbiology spectrum of postcataract surgery endophthalmitis over past two decades in India

PubMed Central

Lalitha, Prajna; Sengupta, Sabyasachi; Ravindran, Ravilla D; Sharma, Savitri; Joseph, Joveeta; Ambiya, Vikas; Das, Taraprasad

2017-01-01

Purpose: The purpose of this study was to review the incidence and microbiology of acute postcataract surgery endophthalmitis in India. Methods: Systematic review of English-language PubMed referenced articles on endophthalmitis in India published in the past 21 years (January 1992–December 2012), and retrospective chart review of 2 major eye care facilities in India in the past 5 years (January 2010–December 2014) were done. The incidence data were collected from articles that described “in-house” endophthalmitis and the microbiology data were collected from all articles. Both incidence and microbiological data of endophthalmitis were collected from two large eye care facilities. Case reports were excluded, except for the articles on cluster infection. Results: Six of 99 published articles reported the incidence of “in-house” acute postcataract surgery endophthalmitis, 8 articles reported the microbiology spectrum, and 11 articles described cluster infection. The clinical endophthalmitis incidence was between 0.04% and 0.15%. In two large eye care facilities, the clinical endophthalmitis incidence was 0.08% and 0.16%; the culture proven endophthalmitis was 0.02% and 0.08%. Gram-positive cocci (44%-64.8%; commonly, Staphylococcus species), and Gram-negative bacilli (26.2%–43%; commonly Pseudomonas species) were common bacteria in south India. Fungi (16.7%-70%; commonly Aspergillus flavus) were the common organisms in north India. Pseudomonas aeruginosa (73.3%) was the major organism in cluster infections. Conclusions: The incidence of postcataract surgery clinical endophthalmitis in India is nearly similar to the world literature. There is a regional difference in microbiological spectrum. A registry with regular and uniform national reporting will help formulate region specific management guidelines. PMID:28820151

A literature review and update on the incidence and microbiology spectrum of postcataract surgery endophthalmitis over past two decades in India.

PubMed

Lalitha, Prajna; Sengupta, Sabyasachi; Ravindran, Ravilla D; Sharma, Savitri; Joseph, Joveeta; Ambiya, Vikas; Das, Taraprasad

2017-08-01

The purpose of this study was to review the incidence and microbiology of acute postcataract surgery endophthalmitis in India. Systematic review of English-language PubMed referenced articles on endophthalmitis in India published in the past 21 years (January 1992-December 2012), and retrospective chart review of 2 major eye care facilities in India in the past 5 years (January 2010-December 2014) were done. The incidence data were collected from articles that described "in-house" endophthalmitis and the microbiology data were collected from all articles. Both incidence and microbiological data of endophthalmitis were collected from two large eye care facilities. Case reports were excluded, except for the articles on cluster infection. Six of 99 published articles reported the incidence of "in-house" acute postcataract surgery endophthalmitis, 8 articles reported the microbiology spectrum, and 11 articles described cluster infection. The clinical endophthalmitis incidence was between 0.04% and 0.15%. In two large eye care facilities, the clinical endophthalmitis incidence was 0.08% and 0.16%; the culture proven endophthalmitis was 0.02% and 0.08%. Gram-positive cocci (44%-64.8%; commonly, Staphylococcus species), and Gram-negative bacilli (26.2%-43%; commonly Pseudomonas species) were common bacteria in south India. Fungi (16.7%-70%; commonly Aspergillus flavus) were the common organisms in north India. Pseudomonas aeruginosa (73.3%) was the major organism in cluster infections. The incidence of postcataract surgery clinical endophthalmitis in India is nearly similar to the world literature. There is a regional difference in microbiological spectrum. A registry with regular and uniform national reporting will help formulate region specific management guidelines.

Lifelong vegetarianism and breast cancer risk: a large multicentre case control study in India.

PubMed

Gathani, Toral; Barnes, Isobel; Ali, Raghib; Arumugham, Rajkumar; Chacko, Raju; Digumarti, Raghunadharao; Jivarajani, Parimal; Kannan, Ravi; Loknatha, Dasappa; Malhotra, Hemant; Mathew, Beela S

2017-01-18

The lower incidence of breast cancer in Asian populations where the intake of animal products is lower than that of Western populations has led some to suggest that a vegetarian diet might reduce breast cancer risk. Between 2011 and 2014 we conducted a multicentre hospital based case-control study in eight cancer centres in India. Eligible cases were women aged 30-70 years, with newly diagnosed invasive breast cancer (ICD10 C50). Controls were frequency matched to the cases by age and region of residence and chosen from the accompanying attendants of the patients with cancer or those patients in the general hospital without cancer. Information about dietary, lifestyle, reproductive and socio-demographic factors were collected using an interviewer administered structured questionnaire. Multivariate logistic regression models were used to estimate the odds ratio (OR) and 95% confidence intervals for the risk of breast cancer in relation to lifelong vegetarianism, adjusting for known risk factors for the disease. The study included 2101 cases and 2255 controls. The mean age at recruitment was similar in cases (49.7 years (SE 9.7)) and controls (49.8 years (SE 9.1)). About a quarter of the population were lifelong vegetarians and the rates varied significantly by region. On multivariate analysis, with adjustment for known risk factors for the disease, the risk of breast cancer was not decreased in lifelong vegetarians (OR 1.09 (95% CI 0.93-1.29)). Lifelong exposure to a vegetarian diet appears to have little, if any effect on the risk of breast cancer.

The Impact of Training on Women's Micro-Enterprise Development. Education Research Paper. Knowledge & Research.

ERIC Educational Resources Information Center

Leach, Fiona; Abdulla, Salwa; Appleton, Helen; el-Bushra, Judy; Cardenas, Nora; Kebede, Kibre; Lewis, Viv; Sitaram, Shashikala

A study investigated the impact of training on women's micro-enterprise development in four programs in Ethiopia, India, Peru, and Sudan. Research design was a series of case studies of projects and programs providing training in technical or business skills. Impact of training was measured against these four indicators: income, access to and…

Gesturing towards Teaching: A Teacher's Narrative

ERIC Educational Resources Information Center

Krishnamurthy, Gopalakrishna

2012-01-01

This is a study of a 20 minute video recorded narrative of a participant-teacher at an inservice teacher education seminar in South India. My analysis involves the close observation of oral and visual elements of this narrative. I employ and deploy this as a telling case to study the conduct and consequences of teaching and educational relations…

Pedagogic Effectiveness of Print, Interactive Multimedia, and Online Resources: A Case Study of IGNOU

ERIC Educational Resources Information Center

Dikshit, Jyotsna; Garg, Suresh; Panda, Santosh

2013-01-01

In the present paper, the authors report on a comparative study on the pedagogic effectiveness of printed self-learning text with face-to-face tutorial support, interactive multimedia CD-ROM and online learning in an introductory computing module at the certificate level offered at Indira Gandhi National Open University (IGNOU), India. The study…

Enhanced tuberculosis case finding through advocacy and sensitisation meetings in prisons of Central India

PubMed Central

Mallick, G.; Agrawal, T. K.; Kumar, A. M. V.; Chadha, S. S.

2017-01-01

Tuberculosis (TB) in prisons is a major problem. The prisons in Chhattisgarh, India, are overcrowded, and there are no formal efforts to engage them in TB control. In 2014, the International Union Against Tuberculosis and Lung Disease and the state TB programme advocated with state prison authorities to implement an enhanced case-finding strategy in the prisons. Sensitisation meetings (one/quarter/prison) to improve awareness among prisoners about TB symptoms and services were coupled with improved access to diagnosis. Patients with presumptive TB who were examined by sputum microscopy increased by 39% per 100 000 prisoners, and TB case notification rates increased by 38%, in 2014 relative to 2013. PMID:28775946

First case report of Moraxella osloensis diarrhea in a hemolytic uremic syndrome/acute renal failure child from rural coastal India-Manipal, Karnataka.

PubMed

Ballal, Mamatha; Martena, Suganthi

2013-03-01

The authors report a rare case of diarrhea caused by Moraxella osloensis in a pediatric child with Hemolytic Uremic Syndrome/Acute Renal Failure (HUS/ARF). A 6-y-old boy was referred to the Pediatric Unit with a 3 d history of bloody diarrhea with mucus and fever and decreased urine output for 6 d. Microbiological investigations were done as per CLSI guidelines. His diarrhea, and the subsequent renal failure resolved with appropriate treatment. To the best of authors' knowledge and pubmed search, this is the first case of M. osloensis causing diarrhea in a HUS/ARF pediatric patient reported from India-Manipal.

Molecular epidemiology of hepatitis A virus infection in Northeast India.

PubMed

Bose, Moumita; Bose, Sujoy; Saikia, Anjan; Medhi, Subhash; Deka, Manab

2015-07-01

The present study was undertaken to screen the molecular epidemiology of Hepatitis A virus (HAV) in Northeast India (NEI) who are ethnically distinct, tribal dominated and of lower socio-economic status with almost no information available from NEI on these aspects. Briefly, 3 ml blood was collected from 324 random liver disease cases with jaundice, receiving care at Central Hospital, N.F. Railway, Guwahati, Assam with informed consent. The patients detected with HAV-IgM positive status were included and were stratified as acute viral hepatitis (AVH) and fulminant hepatitis (FHF) based on clinical profile. Viral RNA was isolated and HAV-RNA was detected by Real-time PCR using primers for the VP3-VP1 region. HAV genotyping was studied by PCR-direct sequencing-phylogenetic analysis approach using the VP1/2A region of HAV isolates. Statistical analysis was performed using SPSS13.0 software. A total of 69 cases were HAV infected with two HBV co-infected cases (n = 69 + 2 = 71), 62 cases and two co-infected cases were AVH and others were FHF cases. HAV infection was predominant in especially in the young and adult age group. HAV-RNA was detected in 28 cases, out of which 19 cases could be genotyped (12 AVH, 7 FHF); which showed the prevalence of genotype IIIA or IA only. Although HAV genotype IIIA was the major genotype in both the AVH (10/12, 83.33%) and FHF (5/7, 71.43%) group, but the difference in distribution of genotypes in AVH and FHF cases was statistically non-significant (P = 0.550). HAV genotype IIIA is associated with the majority of HAV infected cases and severity in NEI. © 2015 Wiley Periodicals, Inc.

Virulence characteristics and genetic affinities of multiple drug resistant uropathogenic Escherichia coli from a semi urban locality in India.

PubMed

Jadhav, Savita; Hussain, Arif; Devi, Savita; Kumar, Ashutosh; Parveen, Sana; Gandham, Nageshwari; Wieler, Lothar H; Ewers, Christa; Ahmed, Niyaz

2011-03-25

Extraintestinal pathogenic Escherichia coli (ExPEC) are of significant health concern. The emergence of drug resistant E. coli with high virulence potential is alarming. Lack of sufficient data on transmission dynamics, virulence spectrum and antimicrobial resistance of certain pathogens such as the uropathogenic E. coli (UPEC) from countries with high infection burden, such as India, hinders the infection control and management efforts. In this study, we extensively genotyped and phenotyped a collection of 150 UPEC obtained from patients belonging to a semi-urban, industrialized setting near Pune, India. The isolates representing different clinical categories were analyzed in comparison with 50 commensal E. coli isolates from India as well as 50 ExPEC strains from Germany. Virulent strains were identified based on hemolysis, haemagglutination, cell surface hydrophobicity, serum bactericidal activity as well as with the help of O serotyping. We generated antimicrobial resistance profiles for all the clinical isolates and carried out phylogenetic analysis based on repetitive extragenic palindromic (rep)-PCR. E. coli from urinary tract infection cases expressed higher percentages of type I (45%) and P fimbriae (40%) when compared to fecal isolates (25% and 8% respectively). Hemolytic group comprised of 60% of UPEC and only 2% of E. coli from feces. Additionally, we found that serum resistance and cell surface hydrophobicity were not significantly (p = 0.16/p = 0.51) associated with UPEC from clinical cases. Moreover, clinical isolates exhibited highest resistance against amoxicillin (67.3%) and least against nitrofurantoin (57.3%). We also observed that 31.3% of UPEC were extended-spectrum beta-lactamase (ESBL) producers belonging to serotype O25, of which four were also positive for O25b subgroup that is linked to B2-O25b-ST131-CTX-M-15 virulent/multiresistant type. Furthermore, isolates from India and Germany (as well as global sources) were found to be genetically distinct with no evidence to espouse expansion of E. coli from India to the west or vice-versa.

Management of diseases caused by thrips-transmitted tospoviruses in subsistence agriculture: the case of Peanut bud necrosis virus in India

USDA-ARS?s Scientific Manuscript database

Among the tospoviruses (genus Tospovirus, family Bunyaviridae) reported in India, Peanut bud necrosis virus is by far the most economically significant for tomato production in subsistence agriculture. Management of PBNV has been a challenge for farmers due to the broad host-range of PBNV and its ve...

Cutaneous Leishmaniasis: Knowledge, Attitude and Practices of the Inhabitants of the Kani Forest Tribal Settlements of Tiruvananthapuram District, Kerala, India

ERIC Educational Resources Information Center

Nandha, B.; Srinivasan, R.; Jambulingam, P.

2014-01-01

Cutaneous leishmaniasis (CL) is reported among Kani tribes in forest settlements of Tiruvananthapuram district, Kerala, India. Epidemiological investigations are ongoing and 27 histopathologically confirmed cases of CL have been reported from five settlements indicating transmission of disease within settlements. One of the priorities for…

India in the Knowledge Economy--An Electronic Paradigm

ERIC Educational Resources Information Center

Bhattacharya, Indrajit; Sharma, Kunal

2007-01-01

Purpose: The purpose of this paper is to make a strong case for investing in information and communication technologies (ICT) for building up of quality human resource capital for economic upliftment of India. An attempt has been made to explore the possibilities of online learning (OL)/e-learning towards building up of quality human resources in…

Differences in public and private sector adoption of telemedicine: Indian case study for sectoral adoption.

PubMed

Sood, Sanjay P; Negash, Solomon; Mbarika, Victor W A; Kifle, Mengistu; Prakash, Nupur

2007-01-01

Telemedicine is the use of communication networks to exchange medical information for providing healthcare services and medical education from one site to another. The application of telemedicine is more promising in economically developing countries with agrarian societies. The American Telemedicine Association (ATA) identifies three healthcare services: clinical medical services, health and medical education, and consumer health information. However, it is not clear how these services can be adopted by different sectors: public and private. This paper looks at four Indian case studies, two each in public and private sectors to understand two research questions: Are there differences in telemedicine adoption between public and private hospitals. If there are differences: What are the differences in telemedicine adoption between public and private sectors? Authors have used the extant literature in telemedicine and healthcare to frame theoretical background, describe the research setting, present the case studies, and provide discussion and conclusions about their findings. Authors believe that as India continues to develop its telemedicine infrastructures, especially with continued government support through subsidies to private telemedicine initiatives, its upward trend in healthcare will continue. This is expected to put India on the path to increase its life expectancy rates, especially for it rural community which constitute over 70% of its populace.

Girls' and Women's Education: Policies and Implementation Mechanisms. Synthesis of Five Case Studies.

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

The national policies and implementation mechanisms for girls' primary and women's basic education in the following Asian countries were examined: Lao People's Democratic Republic; Nepal, Thailand; Indonesia; and India. The analysis focused on the following issues: (1) goals and progress; (2) national policies; (3) strategies (strengthening…

Nonstate Actors and the Open Border Policy: The Border Security Case Study of Nepal and India

DTIC Science & Technology

2014-12-01

Washington headquarters Services, Directorate for Information Operations and Reports. 1215 Jefferson Davis Highway, Suite 1204. Arlington, VA 22202-4302... remuneration .”276 This massive migration of young and eager workers allowed Germany to take advantage of booming industries and markets. The impact on

Widening Access, Widening Participation, Widening Success: An Indian Case Study

ERIC Educational Resources Information Center

Thornton, Mary

2006-01-01

Multiple deprivations are widespread in rural India. Literacy levels remain stubbornly low, albeit gradually improving. Caste, class, religion, gender, age and disability all impact on access to education, participation and successful completion. The education of girls remains problematic given the higher value attached to sons, especially in…

Miscommunication across Cultures: The Case of Marketing in Indian English. Revised.

ERIC Educational Resources Information Center

Frank, Jane

A study of intercultural business communication problems compared three examples of direct marketing sales letters similar in function, format, content, and targeted recipient but originating in different cultures (India, England, and the United States) and companies. The letters were directed to a single prospective purchaser of "Who's…

[Special Report: Adult Education and Primary Health Care.

ERIC Educational Resources Information Center

Vijayendra, T.; And Others

1982-01-01

A series of five case studies examines (1) literacy, health, and conscientization in the Mandar region of India; (2) the training of community health workers in Indonesia; (3) the Chinese strategy combining health, political will, and participation; (4) British community-based health education programs, and (5) participatory methodology for…

Evaluating the Multicultural Curriculum: Student's Perspectives.

ERIC Educational Resources Information Center

Jeffcoate, Robert

1981-01-01

Reports results of a case study which evaluated middle-school students' responses to a cultural awareness unit on India. The class consisted of one Jamaican, ten Indians, and seven English students. Privately taped discussions indicate that the teacher's methods led white students to believe that their views were inadmissable in the classroom. (KC)

Bridging Borders: Global Perspectives in Education

ERIC Educational Resources Information Center

Lath, Meenakshi

2009-01-01

The individualization of curriculum is a challenge for the teacher education system in India. Curricula are prescribed by Universities for all the affiliated colleges, and these undergo revision only every few years. The curriculum innovation described in this report is a response to this challenge. The study explores a unique case of the…

Non Formal Education for Agricultural Workers & Fishermen. A Case Study.

ERIC Educational Resources Information Center

Pillai, K. Sivadasan

An attempt to integrate socioeconomic development with literacy through nonformal education programs in Kerala, India, involved illiterate and semi-literate adults (1050 men, 450 women) in two pilot literacy projects organized by the Sanghom (library organization), Mitraniketan, and state government. Two literacy primers were developed, using an…

Root-Cause Analytical Survey for Measles Outbreak: Vaccination or Vaccine?- A Study From Madhepura District, Bihar, India.

PubMed

Basa, Sudipta; Das, Rashmi Ranjan; Khan, Javed Akhtar

2015-06-01

Though measles is a vaccine preventable disease, outbreaks still continue to occur because of poor immunization coverage rate at the national level. To report the survey results of an outbreak of measles in Puraini village of Madhepura district in Bihar, India. This cross-sectional survey was conducted among children aged 6 months to 12 years during an outbreak of measles in December 2008. WHO case definition criteria was used to define active measles cases. Demographic data, immunization status, and disease outcome among the cases was obtained by pre-structured questionnaires. Blood samples from 5 cases were sent for laboratory confirmation. A total of 52 cases and 8 deaths were reported with an attack rate of 28% and case fatality rate of 15.4%. Out of 35% cases of post-measles complications, dysentery with pneumonia was the most common. Anti-measles IgM antibody tested positive in all the 5 serum samples sent for confirmation. No child had received measles vaccination in the past, and the reasons were lack of awareness, lack of faith on vaccination, and unavailability of health workers. This survey calls for strengthening of disease surveillance and routine immunization coverage to achieve measles control in these communities. This has important public health implication for the whole country regarding measles elimination in near-future.

Dementia in developing countries: Does education play the same role in India as in the West?

PubMed Central

Iyer, Gowri K.; Alladi, Suvarna; Bak, Thomas H.; Shailaja, Mekala; Mamidipudi, Annapurna; Rajan, Amulya; Gollahalli, Divyaraj; Chaudhuri, Jaydip Ray; Kaul, Subhash

2014-01-01

Evidence suggests that education protects from dementia by enhancing cognitive reserve. However, this may be influenced by several socio-demographic factors. Rising numbers of dementia in India, high levels of illiteracy and heterogeneity in socio-demographic factors provide an opportunity to explore this relationship. Objective To study the association between education and age at dementia onset, in relation to socio-demographic factors. Methods Association between age at dementia onset and literacy was studied in relationship to potential confounding factors such as gender, bilingualism, place of dwelling, occupation, vascular risk factors, stroke, family history of dementia and dementia subtypes. Results Case records of 648 dementia patients diagnosed in a specialist clinic in a University hospital in Hyderabad, India were examined. All patients were prospectively enrolled as part of an ongoing longitudinal project that aims to evaluate dementia subjects with detailed clinical, etiological, imaging, and follow-up studies. Of the 648 patients, 98 (15.1%) were illiterate. More than half of illiterate skilled workers were engaged in crafts and skilled agriculture unlike literates who were in trade or clerical jobs. Mean age at onset in illiterates was 60.1 years and in literates 64.5 years (p=0.0002). Factors independently associated with age at dementia onset were bilingualism, rural dwelling and stroke, but not education. Conclusion Our study demonstrates that in India, rural dwelling, bilingualism, stroke and occupation modify the relationship between education and dementia. PMID:29213894

Yield gap analyses to estimate attainable bovine milk yields and evaluate options to increase production in Ethiopia and India.

PubMed

Mayberry, Dianne; Ash, Andrew; Prestwidge, Di; Godde, Cécile M; Henderson, Ben; Duncan, Alan; Blummel, Michael; Ramana Reddy, Y; Herrero, Mario

2017-07-01

Livestock provides an important source of income and nourishment for around one billion rural households worldwide. Demand for livestock food products is increasing, especially in developing countries, and there are opportunities to increase production to meet local demand and increase farm incomes. Estimating the scale of livestock yield gaps and better understanding factors limiting current production will help to define the technological and investment needs in each livestock sector. The aim of this paper is to quantify livestock yield gaps and evaluate opportunities to increase dairy production in Sub-Saharan Africa and South Asia, using case studies from Ethiopia and India. We combined three different methods in our approach. Benchmarking and a frontier analysis were used to estimate attainable milk yields based on survey data. Household modelling was then used to simulate the effects of various interventions on dairy production and income. We tested interventions based on improved livestock nutrition and genetics in the extensive lowland grazing zone and highland mixed crop-livestock zones of Ethiopia, and the intensive irrigated and rainfed zones of India. Our analyses indicate that there are considerable yield gaps for dairy production in both countries, and opportunities to increase production using the interventions tested. In some cases, combined interventions could increase production past currently attainable livestock yields.

Study of the Relationship between Study Habits and Academic Achievement of Students: A Case of Spicer Higher Secondary School, India

ERIC Educational Resources Information Center

Siahi, Evans Atsiaya; Maiyo, Julius K.

2015-01-01

The studies on the correlation of academic achievement have paved way for control and manipulation of related variables for quality results in schools. In spite of the facts that schools impart uniform classroom instructions to all students, wide range of difference is observed in their academic achievement. The study sought to determine the…

Virological investigation of hand, foot, and mouth disease in a tertiary care center in South India.

PubMed

Vijayaraghavan, Pavithra M; Chandy, Sara; Selvaraj, Kavitha; Pulimood, Susanne; Abraham, Asha M

2012-07-01

Hand, foot, and mouth disease (HFMD) remains a common problem in India, yet its etiology is largely unknown as diagnosis is based on clinical characteristics. There are very few laboratory-based molecular studies on HFMD outbreaks. The aim of this study was to characterize HFMD-related isolates by molecular techniques. Between 2005 and 2008, during two documented HFMD outbreaks, 30 suspected HFMD cases presented at the Outpatient Unit of the Department of Dermatology, Christian Medical College (CMC), Vellore. Seventy-eight clinical specimens (swabs from throat, mouth, rectum, anus, buttocks, tongue, forearm, sole, and foot) were received from these patients at the Department of Clinical Virology, CMC, for routine diagnosis of hand, foot, and mouth disease. Samples from these patients were cultured in Vero and rhabdomyosarcoma (RD) cell lines. Isolates producing enterovirus-like cytopathogenic effect (CPE) in cell culture were identified by a nested reverse transcription-based polymerase chain reaction (RT-PCR) and sequenced. The nucleotide sequences were analyzed using the BioEdit sequence program. Homology searches were performed using the Basic Local Alignment Search Tool (BLAST) algorithm. The statistical analysis was performed using Epi Info version 6.04b and Microsoft Excel 2002 (Microsoft Office XP). Of the 30 suspected HFMD cases, only 17 (57%) were laboratory confirmed and Coxsackievirus A16 (CVA16) was identified as the etiological agent in all these cases. Coxsackievirus A16 (CVA16) was identified as the virus that caused the HFMD outbreaks in Vellore between 2005 and 2008. Early confirmation of HFMD helps to initiate control measures to interrupt virus transmission. In the laboratory, classical diagnostic methods, culture and serological tests are being replaced by molecular techniques. Routine surveillance systems will help understand the epidemiology of HFMD in India.

A demographic dividend of the FP2020 Initiative and the SDG reproductive health target: Case studies of India and Nigeria

PubMed Central

Li, Qingfeng; Rimon, Jose G.

2018-01-01

Background: The demographic dividend, defined as the economic growth potential resulting from favorable shifts in population age structure following rapid fertility decline, has been widely employed to advocate improving access to family planning. The current framework focuses on the long-term potential, while the short-term benefits may also help persuade policy makers to invest in family planning. Methods: We estimate the short- and medium-term economic benefits from two major family planning goals: the Family Planning 2020 (FP2020)’s goal of adding 120 million modern contraceptive users by 2020; Sustainable Development Goals (SDG) 3.7 of ensuring universal access to family planning by 2030. We apply the cohort component method to World Population Prospects and National Transfer Accounts data. India and Nigeria, respectively the most populous Asian and African country under the FP2020 initiative, are used as case studies. Results: Meeting the FP2020 target implies that on average, the number of children that need to be supported by every 100 working-age people would decrease by 8 persons in India and 11 persons in Nigeria in 2020; the associated reduction remains at 8 persons in India, but increases to 14 persons in Nigeria by 2030 under the SDG 3.7. In India meeting the FP2020 target would yield a saving of US$18.2 billion (PPP) in consumption expenditures for children and youth in the year 2020 alone, and that increased to US$89.7 billion by 2030. In Nigeria the consumption saved would be US$2.5 billion in 2020 and $12.9 billion by 2030. Conclusions: The tremendous economic benefits from meeting the FP2020 and SDG family planning targets demonstrate the cost-effectiveness of investment in promoting access to contraceptive methods. The gap already apparent between the observed and targeted trajectories indicates tremendous missing opportunities. Accelerated progress is needed to achieve the FP2020 and SDG goals and so reap the demographic dividend. PMID:29630076

Evaluating clinicians' user experience and acceptability of LearnTB, a smartphone application for tuberculosis in India.

PubMed

Pande, Tripti; Saravu, Kavitha; Temesgen, Zelalem; Seyoum, Al; Rai, Shipra; Rao, Raghavendra; Mahadev, Deekshith; Pai, Madhukar; Gagnon, Marie-Pierre

2017-01-01

Tuberculosis (TB) is the leading infectious killer, and India accounts for 2.8 of the 10.4 million TB cases that occur each year, making it the highest TB burden country worldwide. Poor quality of TB care is a major driver of the epidemic in India. India's large private, unregulated sector manages over 50% of the TB patients, with studies showing suboptimal diagnosis and treatment in the private sector. Better education of doctors using mobile applications (apps) is a possible solution. While India has seen an explosion of mobile phone services, and while the use of mobile health interventions has been gaining interest, little is known about mHealth around tuberculosis in India. Our study aimed to understand the user experience and acceptability of a smartphone application, LearnTB , amongst private sector academic clinicians in India. This study was conducted amongst 101 clinicians at Kasturba Hospital, Manipal, India. The user experience of participants (part 1) and acceptability (part 2) were evaluated with the use of two valid, English, paper-based questionnaires. The first questionnaire was based on the System Usability Scale (SUS); the second questionnaire was based on the Technology Acceptance Model (TAM). Data were collected during February and March 2017 and were analyzed using descriptive statistics, multiple linear regression as well as logistic regression analysis. A response rate of 99% was achieved; 100 participants responded to the second questionnaire and 100% of the participants responded to the first questionnaire. User experience was very high [mean SUS score =94.4 (92.07-96.76)]. Perceived usefulness (PU) was significantly correlated to intention to use (IU) (r=0.707, P<0.0001), and perceived ease of use (PEU) was significantly correlated to PU (r=0.466, P<0.0001). Path analysis confirmed the direct relationship between PU and IU (0.936, P<0.0001), and the indirect relationship between PEU and IU (0.5102, P<0.0001). Logistic regression analysis helped target items strongly influencing IU, such as "The use of the LearnTB application is compatible with my work habits" [OR =3.20 (1.04-9.84), P=0.004] and "The use of the LearnTB application could promote good clinical practice" [OR =5.23 (1.35-20.29); P=0.016]. The first part of the study indicated high user experience of the LearnTB application. The TAM questionnaire (second part) explained a significant portion of the variance in clinicians' IU the LearnTB application. The PU of the application has the highest impact on the clinicians' IU the Learn TB application. This study provides a preliminary analysis of mobile health interventions for tuberculosis in India, and emphasizes the need for future research in this domain.

Potential impact of a 9-valent HPV vaccine in HPV-related cervical disease in 4 emerging countries (Brazil, Mexico, India and China).

PubMed

Serrano, Beatriz; Alemany, Laia; Ruiz, Patricia Alonso de; Tous, Sara; Lima, Marcus Aurelho; Bruni, Laia; Jain, Asha; Clifford, Gary M; Qiao, You Lin; Weiss, Thomas; Bosch, F Xavier; de Sanjosé, Silvia

2014-12-01

We estimated the potential impact of an investigational 9-valent human papillomavirus (HPV) vaccine (HPVs 6/11/16/18/31/33/45/52/58) in HPV-related cervical disease in Brazil, Mexico, India and China, to help to formulate recommendations on cervical cancer prevention and control. Estimations for invasive cervical cancer (ICC) were based on an international study including 1356 HPV-positive cases for the four countries altogether, and estimations for precancerous cervical lesions were extracted from a published meta-analysis including 6 025 HPV-positive women from the four mentioned countries. Globocan 2012 and 2012 World Population Prospects were used to estimate current and future projections of new ICC cases. Combined proportions of the 9 HPV types in ICC were 88.6% (95%CI: 85.2-91.3) in Brazil, 85.7% (82.3-88.8) in Mexico, 92.2% (87.9-95.3) in India and 97.3% (93.9-99.1) in China. The additional HPV 31/33/45/52/58 proportions were 18.8% (15.3-22.7) in Brazil, 17.6% (14.2-21.2) in Mexico, 11.3% (7.5-16.1) in India and 11.9% (7.5-17.2) in China. HPV6 and 11 single types were not identified in any of the samples. Proportion of the individual 7 high risk HPV types included in the vaccine varied by cytological and histological grades of HPV-positive precancerous cervical lesions. HPV 16 was the dominant type in all lesions, with contributions in low grade lesions ranging from 16.6%(14.3-19.2) in Mexico to 39.8% (30.0-50.2) in India, and contributions in high grade lesions ranging from 43.8% (36.3-51.4) in Mexico to 64.1% (60.6-67.5) in Brazil. After HPV 16, variations in other majors HPV types were observed by country, with an under representation of HPV 18 and 45 compared to ICC. The addition of HPVs 31/33/45/52/58 to HPV types included in current vaccines could increase the ICC preventable fraction in a range of 12 to 19% across the four countries, accounting the 9-types altogether 90% of ICC cases. Assuming the same degree of efficacy of current vaccines, the implementation of the 9-valent HPV vaccine in Brazil, Mexico, India and China would substantially impact on the reduction of the world cervical cancer burden. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Chandipura virus infection causing encephalitis in a tribal population of Odisha in eastern India.

PubMed

Dwibedi, Bhagirathi; Sabat, Jyotsnamayee; Hazra, Rupenangshu K; Kumar, Anu; Dinesh, Diwakar Singh; Kar, Shantanu K

2015-01-01

The sudden death of 10 children in a tribal village of Kandhamal district, Odisha in eastern India led to this investigation. We conducted a door-to-door survey to identify cases. Antibodies for Chandipura, Japanese encephalitis, dengue, chikungunya and West Nile viruses were tested by ELISA in probable cases. Chandipura virus RNA was tested from both human blood samples and sand flies by reverse transcriptase polymerase chain reaction. We conducted vector surveys in domestic and peridomestic areas, and collected sand flies. Entomological investigations revealed the presence of Phlebotomus argentipes and Sergentomiya sp. Thirty-five patients presented with fever, 12 of them had altered sensorium including 4 who had convulsions. The blood samples of 21 patients were tested; four samples revealed Chandipura virusspecific IgM antibody. Chandipura virus infection causing encephalitis affected this tribal population in eastern India at 1212 m above sea level. Copyright 2015, NMJI.

Delirium in elderly people: a study of a psychiatric liaison service in north India.

PubMed

Grover, Sandeep; Kate, Natasha; Agarwal, Munish; Mattoo, Surendra Kumar; Avasthi, Ajit; Malhotra, Savita; Kulhara, Parmanand; Chakrabarti, Subho; Basu, Debasish

2012-01-01

Very few studies from India have studied the phenomenology of delirium. The aim of the present study was to study the phenomenology as measured using the Delirium Rating Scale-Revised-98 (DRS-R98), the associated etiologies and the outcome of delirium among the elderly participants seen by the consultation-liaison psychiatric service in India. In addition, an attempt was made to study the factor structure of symptoms using principal components analysis. The case notes of 109 elderly patients referred to psychiatry liaison services were reviewed. The mean age of the sample was 73.35 years (SD: 7.44; range 65-95 years) and two-thirds of the sample had hospital emergent delirium. The mean DRS-R98 severity score was 18.77 and the DRS-R98 total score was 24.81. In 15 patients the DRS-R98 scores were in the subsyndromal range. Among the various symptoms present, most patients had sleep-wake cycle disturbance, disturbance in orientation, attention and short-term memory impairments, fluctuation of symptoms, temporal onset of symptoms and a physical disorder. Principal components analysis identified three factors which explained 43.5% of variance of symptomatology and it yielded a three-factor structure. Endocrine/metabolic disturbances were the commonest associated etiological category with delirium. The mean hospital stay after being referred to psychiatry referral services was 8.89 days, after which delirium improved in 58.7% of cases. The mortality rate during the inpatient stay was 16.5%. Results suggest that the symptoms of delirium as assessed by DRS-R98 separate out into a three-factor structure. Delirium is commonly associated with metabolic endocrine disturbances and about one-sixth of the patients die during the short inpatient stay.

Climate change-induced heat risks for migrant populations working at brick kilns in India: a transdisciplinary approach.

PubMed

Lundgren-Kownacki, Karin; Kjellberg, Siri M; Gooch, Pernille; Dabaieh, Marwa; Anandh, Latha; Venugopal, Vidhya

2018-03-01

During the summer of 2015, India was hit by a scorching heat wave that melted pavements in Delhi and caused thousands of deaths, mainly among the most marginalized populations. One such group facing growing heat risks from both occupational and meteorological causes are migrant brick kiln workers. This study evaluates both current heat risks and the potential future impacts of heat caused by climate change, for the people working at brick kilns in India. A case study of heat stress faced by people working at brick kilns near Chennai, India, is the anchor point around which a transdisciplinary approach was applied. Around Chennai, the situation is alarming since occupational heat exposure in the hot season from March to July is already at the upper limits of what humans can tolerate before risking serious impairment. The aim of the study was to identify new pathways for change and soft solutions by both reframing the problem and expanding the solution space being considered in order to improve the quality of life for the migrant populations at the brick kilns. Technical solutions evaluated include the use of sun-dried mud bricks and other locally "appropriate technologies" that could mitigate the worsening of climate change-induced heat. Socio-cultural solutions discussed for empowering the people who work at the brick kilns include participatory approaches such as open re-localization, and rights-based approaches including the environmental sustainability and the human rights-based approach framework. Our analysis suggests that an integrative, transdisciplinary approach could incorporate a more holistic range of technical and socio-culturally informed solutions in order to protect the health of people threatened by India's brick kiln industry.

Climate change-induced heat risks for migrant populations working at brick kilns in India: a transdisciplinary approach

NASA Astrophysics Data System (ADS)

Lundgren-Kownacki, Karin; Kjellberg, Siri M.; Gooch, Pernille; Dabaieh, Marwa; Anandh, Latha; Venugopal, Vidhya

2018-03-01

During the summer of 2015, India was hit by a scorching heat wave that melted pavements in Delhi and caused thousands of deaths, mainly among the most marginalized populations. One such group facing growing heat risks from both occupational and meteorological causes are migrant brick kiln workers. This study evaluates both current heat risks and the potential future impacts of heat caused by climate change, for the people working at brick kilns in India. A case study of heat stress faced by people working at brick kilns near Chennai, India, is the anchor point around which a transdisciplinary approach was applied. Around Chennai, the situation is alarming since occupational heat exposure in the hot season from March to July is already at the upper limits of what humans can tolerate before risking serious impairment. The aim of the study was to identify new pathways for change and soft solutions by both reframing the problem and expanding the solution space being considered in order to improve the quality of life for the migrant populations at the brick kilns. Technical solutions evaluated include the use of sun-dried mud bricks and other locally "appropriate technologies" that could mitigate the worsening of climate change-induced heat. Socio-cultural solutions discussed for empowering the people who work at the brick kilns include participatory approaches such as open re-localization, and rights-based approaches including the environmental sustainability and the human rights-based approach framework. Our analysis suggests that an integrative, transdisciplinary approach could incorporate a more holistic range of technical and socio-culturally informed solutions in order to protect the health of people threatened by India's brick kiln industry.

Partition and poliomyelitis: an investigation of the polio disparity affecting Muslims during India's eradication program.

PubMed

Hussain, Rashid S; McGarvey, Stephen T; Fruzzetti, Lina M

2015-01-01

Significant disparities in the incidence of polio existed during its eradication campaign in India. In 2006, Muslims, who comprise 16% of the population in affected states, comprised 70% of paralytic polio cases. This disparity was initially blamed on the Muslims and a rumor that the vaccination program was a plot to sterilize their children. Using the framework of structural violence, this paper describes how the socio-political and historical context of Muslim populations in India shaped the polio disparity. A qualitative study utilizing methods of rapid ethnography was conducted from May-August 2009 in Aligarh, Uttar Pradesh, India. Field methods included participant observation of vaccination teams, historical document research, and 107 interviews with both Global Polio Eradication Initiative (GPEI) stakeholders and families with vaccine-eligible children. Almost all respondents agreed that Aligarh was a highly segregated city, mostly due to riots after Partition and during the 1990s. Since the formation of segregated neighborhoods, most respondents described that "Muslim areas" had been underdeveloped compared to "Hindu areas," facilitating the physical transmission of poliovirus. Distrust of the government and resistance to vaccination were linked to this disparate development and fears of sterilization influenced by the "Family Planning Program" from 1976-1977. Ethnic violence and social marginalization since the Partition and during the rise of Hindu nationalism led to distrust of the government, the formation of segregated slums, and has made Muslims victims of structural violence. This led to the creation of disease-spreading physical environments, lowered vaccine efficacy, and disproportionately higher levels of resistance to vaccination. The causes of the polio disparity found in this study elucidate the nature of possible other health disparities affecting minorities in India. This study is limited by the manual coding of the transcribed data, size, and some dialectal difficulties in translation.

CO2 Emissions from Direct Energy Use of Urban Households in India.

PubMed

Ahmad, Sohail; Baiocchi, Giovanni; Creutzig, Felix

2015-10-06

India hosts the world's second largest population and offers the world's largest potential for urbanization. India's urbanization trajectory will have crucial implications on its future GHG emission levels. Using household microdata from India's 60 largest cities, this study maps GHG emissions patterns and its determinants. It also ranks the cities with respect to their household actual and "counter-factual" GHG emissions from direct energy use. We find that household GHG emissions from direct energy use correlate strongly with income and household size; population density, basic urban services (municipal water, electricity, and modern cooking-fuels access) and cultural, religious, and social factors explain more detailed emission patterns. We find that the "greenest" cities (on the basis of household GHG emissions) are Bareilly and Allahabad, while the "dirtiest" cities are Chennai and Delhi; however, when we control for socioeconomic variables, the ranking changes drastically. In the control case, we find that smaller lower-income cities emit more than expected, and larger high-income cities emit less than expected in terms of counter-factual emissions. Emissions from India's cities are similar in magnitude to China's cities but typically much lower than those of comparable U.S. cities. Our results indicate that reducing urban heat-island effects and the associated cooling degree days by greening, switching to modern nonsolid cooking fuels, and anticipatory transport infrastructure investments are key policies for the low-carbon and inclusive development of Indian cities.

Mucormycosis at a tertiary care centre in Gujarat, India.

PubMed

Patel, Atul K; Patel, Ketan K; Patel, Kamlesh; Gohel, Swati; Chakrabarti, Arunaloke

2017-06-01

The prevalence of mucormycosis is reportedly high in India, although the studies are mainly from north and south India only. We analysed the mucormycosis cases at tertiary care centres of West India. We retrieved the clinical details of all the patients with probable and proven mucormycosis diagnosed at Sterling Hospital and ID clinic at Ahmedabad, Gujarat over the period from 1 January 2013 through 30 April 2015. The data were analysed to determine demography, risk factors, underlying diseases, site of infection and outcome of these patients. A total of 27 patients with the median age of 50 (16-65) years were diagnosed with mucormycosis during the period. Rhino-orbital-cerebral mucormycosis was the most common (51.9%) presentation. Majority (55.6%) of the patients had uncontrolled diabetes with or without ketoacidosis; 25.9% patients had no underlying disease and most of them (85.7%) had cutaneous mucormycosis. In this group, the mortality was 25.9% and an equal percentage of patients were lost to follow up; 14 (51.9%) patients could complete 6 weeks of amphotericin B therapy. All patients who completed antifungal therapy survived except one. Like other parts of India, uncontrolled diabetes was the predominant risk factor for mucormycosis in our group. Patients completing 6 weeks of amphotericin B treatment were likely to survive. © 2017 Blackwell Verlag GmbH.

Paragonimus & paragonimiasis in India

PubMed Central

Singh, T. Shantikumar; Sugiyama, Hiromu; Rangsiruji, Achariya

2012-01-01

Ever since the discovery of the first indigenous case in 1981, paragonimiasis has gained recognition as a significant food borne parasitic zoonosis in India. The data available on the occurrence of paragonimiasis, until today, may be just the tip of an iceberg as the study areas covered were restricted to Northeast Indian States. Nevertheless, the results of research on paragonimiasis in India have revealed valuable information in epidemiology, life cycle, pathobiology and speciation of Indian Paragonimus. Potamiscus manipurensis, Alcomon superciliosum and Maydelliathelphusa lugubris were identified as the crab hosts of Paragonimus. Paragonimus miyazakii manipurinus n. sub sp., P. hueit’ungensis, P. skrjabini, P. heterotremus, P. compactus, and P. westermani have been described from India. P. heterotremus was found as the causative agent of human paragonimiasis. Ingestion of undercooked crabs and raw crab extract was the major mode of infection. Pulmonary paragonimiasis was the commonest clinical manifestation while pleural effusion and subcutaneous nodules were the common extra-pulmonary forms. Clinico-radiological features of pulmonary paragonimiasis simulated pulmonary tuberculosis. Intradermal test, ELISA and Dot-immunogold filtration assay (DIGFA) were used for diagnosis and epidemiological survey of paragonimiasis. Phylogenitically, Indian Paragonimus species, although nested within the respective clade were distantly related to others within the clade. PMID:22960885

Malnutrition among under-five children in India and strategies for control

PubMed Central

Sahu, Swaroop Kumar; Kumar, S. Ganesh; Bhat, B. Vishnu; Premarajan, K. C.; Sarkar, Sonali; Roy, Gautam; Joseph, Nitin

2015-01-01

Malnutrition among under-five children is an important concern for the health authorities in India. The aim of the present review was to assess the burden of under-nutrition and over-nutrition, its determinants and strategies required to tackle malnutrition among under-five children in India. Recent data were collected from Google search, Medline, and others. The information retrieved was reviewed and analyzed for discrepancies. Existing evidence shows that the prevalence of under-nutrition among under-five children was high and varied widely (under-weight: 39-75%, stunting: 15.4-74%, wasting: 10.6-42.3%) depending on the assessment methodology adopted. Studies on assessment of over-nutrition status among under-five children were limited. Distribution of various types of risk factors and its influence on nutrition status of children in a given set up should be analyzed for planning the control measures. Strengthening public health interventions for mild malnutrition cases and vulnerable groups, effective implementation and evaluation of the strategies at regional level, research on overweight, obesity and its etiological factors and steps for improving socioeconomic development are the prerequisites for tackling malnutrition among under-five children in India. PMID:25810629

Bioinformatics education in India.

PubMed

Kulkarni-Kale, Urmila; Sawant, Sangeeta; Chavan, Vishwas

2010-11-01

An account of bioinformatics education in India is presented along with future prospects. Establishment of BTIS network by Department of Biotechnology (DBT), Government of India in the 1980s had been a systematic effort in the development of bioinformatics infrastructure in India to provide services to scientific community. Advances in the field of bioinformatics underpinned the need for well-trained professionals with skills in information technology and biotechnology. As a result, programmes for capacity building in terms of human resource development were initiated. Educational programmes gradually evolved from the organisation of short-term workshops to the institution of formal diploma/degree programmes. A case study of the Master's degree course offered at the Bioinformatics Centre, University of Pune is discussed. Currently, many universities and institutes are offering bioinformatics courses at different levels with variations in the course contents and degree of detailing. BioInformatics National Certification (BINC) examination initiated in 2005 by DBT provides a common yardstick to assess the knowledge and skill sets of students passing out of various institutions. The potential for broadening the scope of bioinformatics to transform it into a data intensive discovery discipline is discussed. This necessitates introduction of amendments in the existing curricula to accommodate the upcoming developments.

Dengue in India

PubMed Central

Gupta, Nivedita; Srivastava, Sakshi; Jain, Amita; Chaturvedi, Umesh C.

2012-01-01

Dengue virus belongs to family Flaviviridae, having four serotypes that spread by the bite of infected Aedes mosquitoes. It causes a wide spectrum of illness from mild asymptomatic illness to severe fatal dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS). Approximately 2.5 billion people live in dengue-risk regions with about 100 million new cases each year worldwide. The cumulative dengue diseases burden has attained an unprecedented proportion in recent times with sharp increase in the size of human population at risk. Dengue disease presents highly complex pathophysiological, economic and ecologic problems. In India, the first epidemic of clinical dengue-like illness was recorded in Madras (now Chennai) in 1780 and the first virologically proved epidemic of dengue fever (DF) occurred in Calcutta (now Kolkata) and Eastern Coast of India in 1963-1964. During the last 50 years a large number of physicians have treated and described dengue disease in India, but the scientific studies addressing various problems of dengue disease have been carried out at limited number of centres. Achievements of Indian scientists are considerable; however, a lot remain to be achieved for creating an impact. This paper briefly reviews the extent of work done by various groups of scientists in this country. PMID:23041731

Mapping of wasteland of india: A case study of Bangalore district of Karnataka

NASA Astrophysics Data System (ADS)

Behera, G.; Dutt, C. B. S.; Nageswara Rao, P. P.; Gupta, A. K.; Krishnamurthy, J.; Ganesharaj, K.; Padmavathy, A. S.; Yogarajan, N.

India is the second most populous country in the world. Its economy is agrarian in nature. Increasing demand for food, fodder, fuel and fibre has necessitated adoption of scientific measures for increase in land productivity and bringing more areas under cultivation/forests. However land degradation due to desertification, soil salinity, waterlogging, floods/drought, excessive soil erosion due to deforestation, unscientific agricultural practices etc. have resulted in the creation of vast stretches of wastelands and a decrease in per capita cultivable land besides ecological imbalance. Nearly 53 Mha are wasteland and 22 Mha of land have problems of either salinity, alkalinity, soil erosion, waterlogging, shifting cultivation or presently unused because of their undulating nature. Only 11% of India's geographic area is under effective tree cover. Forest degradation has increased by 14% over last 8-10 years. The land area prone to floods has doubled from 20 Mha to about 40 Mha in last 10 years. Awareness of this fact has resulted in the formation of the "National Wasteland Development Board" (NWDB) under the aegis of National Landuse and Wasteland Development Council (NLWC) with the Chairmanship of the Prime Minister of India.

Stakeholder-based SWOT analysis for successful municipal solid waste management in Lucknow, India.

PubMed

Srivastava, P K; Kulshreshtha, K; Mohanty, C S; Pushpangadan, P; Singh, A

2005-01-01

The present investigation is a case study of Lucknow, the main metropolis in Northern India, which succumbs to a major problem of municipal solid waste and its management. A qualitative investigation using strengths, weaknesses, opportunities and threats analysis (SWOT) has been successfully implemented through this community participation study. This qualitative investigation emphasizes the limited capabilities of the municipal corporation's resources to provide proper facilitation of the municipal solid waste management (MSWM) services without community participation in Lucknow city. The SWOT analysis was performed to formulate strategic action plans for MSWM in order to mobilize and utilize the community resources on the one hand and municipal corporation's resources on the other. It has allowed the introduction of a participatory approach for better collaboration between the community and municipal corporation in Lucknow (India). With this stakeholder-based SWOT analysis, efforts were made to explore the ways and means of converting the possible "threats" into "opportunities" and changing the "weaknesses" into "strengths" regarding a community-based MSWM programme. By this investigation, concrete strategic action plans were developed for both the community and municipal corporation to improve MSWM in Lucknow.

Consortia for Engineering, Science and Technology Libraries in India: A Case Study of INDEST Consortium

NASA Astrophysics Data System (ADS)

Pathak, S. K.; Deshpande, N. J.

2007-10-01

The present scenario of the INDEST Consortium among engineering, science and technology (including astronomy and astrophysics) libraries in India is discussed. The Indian National Digital Library in Engineering Sciences & Technology (INDEST) Consortium is a major initiative of the Ministry of Human Resource Development, Government of India. The INDEST Consortium provides access to 16 full text e-resources and 7 bibliographic databases for 166 institutions as members who are taking advantage of cost effective access to premier resources in engineering, science and technology, including astronomy and astrophysics. Member institutions can access over 6500 e-journals from 1092 publishers. Out of these, over 150 e-journals are exclusively for the astronomy and physics community. The current study also presents a comparative analysis of the key features of nine major services, viz. ACM Digital Library, ASCE Journals, ASME Journals, EBSCO Databases (Business Source Premier), Elsevier's Science Direct, Emerald Full Text, IEEE/IEE Electronic Library Online (IEL), ProQuest ABI/INFORM and Springer Verlag's Link. In this paper, the limitations of this consortium are also discussed.

Molecular characterization of Shiga-toxigenic Escherichia coli isolated from diverse sources from India by multi-locus variable number tandem repeat analysis (MLVA).

PubMed

Kumar, A; Taneja, N; Sharma, R K; Sharma, H; Ramamurthy, T; Sharma, M

2014-12-01

In a first study from India, a diverse collection of 140 environmental and clinical non-O157 Shiga-toxigenic Escherichia coli strains from a large geographical area in north India was typed by multi-locus variable number tandem repeat analysis (MLVA). The distribution of major virulence genes stx1, stx2 and eae was found to be 78%, 70% and 10%, respectively; 15 isolates were enterohaemorrhagic E. coli (stx1 +/stx2 + and eae +). By MLVA analysis, 44 different alleles were obtained. Dendrogram analysis revealed 104 different genotypes and 19 MLVA-type complexes divided into two main lineages, i.e. mutton and animal stool. Human isolates presented a statistically significant greater odds ratio for clustering with mutton samples compared to animal stool isolates. Five human isolates clustered with animal stool strains suggesting that some of the human infections may be from cattle, perhaps through milk, contact or the environment. Further epidemiological studies are required to explore these sources in context with occurrence of human cases.

Global Adult Tobacco Survey (GATS): a case for change in definition, analysis and interpretation of "cigarettes" and "cigarettes per day" in completed and future surveys.

PubMed

Jena, Pratap Kumar; Kishore, Jugal; Sarkar, Bidyut K

2013-01-01

The Global Adult Tobacco Survey has 15 key indicators, cigarettes smoked per day (CPD) among daily smokers being one of them. The first wave of GATS in 14 countries indicated that mean CPD use is higher in women than men in India only, which is contrary to the current understanding of tobacco use globally. This study was undertaken to understand the unusual findings for mean CPD use in the GATS-India survey. Items B06a and B06b of the GATS India survey questionnaire that collected information on daily consumption of manufactured and rolled cigarettes were analyzed using SPSS software. Exclusive users were identified from these items after excluding the concurrent users of other tobacco products. Cigarette type, exclusive use and gender stratified analyses were made. Consumption of different types of cigarettes among the mixed users of manufactured and rolled cigarettes were correlated. Higher mean number of CPD use among male daily-smokers was observed than their female counterparts in product specific analysis. Mean CPD as per GATS cigarette definition was higher in males than females for exclusive users but a reverse trend was observed in case of non-exclusive users. Use of manufactured cigarettes increased with increase in use of rolled cigarette among the mixed users and around half of these users reported equal CPD frequency for the both types of cigarettes. The anomaly in mean CPD estimate in GATS-India data was due to inclusion of two heterogeneous products to define cigarettes, variation in cigarette product specific user proportions contributing to the average and non-exclusive concurrent use of other tobacco products. The consumption pattern of cigarettes among the mixed users highlights bias in CPD reporting. Definition, analysis and interpretation of 'cigarettes per day' in the GATS India survey need to be improved by redefining cigarettes and making product specific analyses.

Prevalence and characteristics of Molar Incisor Hypomineralisation (MIH) in the child population residing in Gandhinagar, Gujarat, India.

PubMed

Parikh, D R; Ganesh, M; Bhaskar, V

2012-02-01

Most prevalence studies on Molar Incisor Hypomineralisation (MIH) have been carried out in European countries and data from Asia especially south Asian populations are lacking. To investigate the prevalence and clinical characteristics of MIH in children residing in a western region of India. A cross-sectional survey including 1,366 children from 5 age cohorts, 8-12 years, studying in primary schools or attending the University Department, was carried out in the area of Gandhinagar, Gujarat, India. The dental examination was performed by a single well-trained and calibrated examiner in day light conditions. Full mouth inspection of wet teeth was conducted using the EAPD 2003 criteria for diagnosis of MIH. Results were recorded and statistically analysed using Chi-square test, independent sample t-test and Pearson correlations. Prevalence of MIH was 9.2% in the examined population. Males and females were equally affected. Among 12 index teeth involved in the examination, the most commonly affected were in descending order 46, 36, 16, 11 [FDI] and the least 42, 32, and 22. 17.4% of the cases revealed only molars involved, the remaining 72.6% having both molars and incisors affected; all four first permanent molars showed in 23% of the cases while no cases of only affected incisors were found. Of the MIH teeth 77.3% revealed mild defects and 22.7% severe defects. All incisors were mildly affected, as compared with only 67.1% of the molars, the remaining 32.9% being severely affected. As age increased, a statistically significant larger total number and severity level of affected teeth were recorded. Prevalence of MIH using EAPD 2003 criteria was found to be similar to other studies evaluating children in different geographic locations such as Europe, South America etc. Using the EAPD standardised criteria, more studies should be conducted in other Indian regions, in order to further evaluate prevalence, characteristics and treatment needs for this clinically demanding condition.

Gender differences, routes of transmission, socio-demographic characteristics and prevalence of HIV related infections of adults and children in an HIV cohort from a rural district of India.

PubMed

Alvarez-Uria, Gerardo; Midde, Manoranjan; Pakam, Raghavakalyam; Naik, Praveen Kumar

2012-01-02

Despite 67% of HIV infected people in India are rural residents, the epidemiology of HIV in rural areas is not well known. This is an observational cohort study of 11,040 HIV infected people living in a rural district of India. The prevalence of hepatitis B, hepatitis C and syphilis of HIV infected patients were compared to the seroprevalence in 16,641 blood donors from the same area. The age of diagnosis in adults was below 35 years in 70% of cases and 56% were illiterate. One third of women were widows and only 3.6% of adults had a permanent job. Women were diagnosed at earlier age, had lower level of education, had poorer employment conditions and depended more on their relatives than men. In a survey performed to a subgroup of patients, 81% of women referred to have acquired HIV from their spouse, whereas 51% of men acquired HIV from commercial sex. Patients with HIV had significantly higher prevalence of hepatitis B, hepatitis C and syphilis than blood donors. Seroprevalence of HIV-2, hepatitis C and toxoplasmosis were low compared to other sites. Six percent were children (<15 years) and almost half of them had lost one or both of their parents. The study shows the poor socio-economical situation and the high level of illiteracy of people living with HIV in rural India, especially women. Future health programmes of HIV in India should take into account the particularities of the HIV epidemic in rural areas.

An ocular cysticercosis case: Caused by Asian genotype of Taenia solium.

PubMed

Sharma, M; Beke, N; Khurana, S; Bhatti, H S; Sehgal, R; Malla, N

2015-01-01

An ocular cysticercosis case of a 42-year-old male, who presented with anterior uveitis is being reported. Microscopical examination of the cyst revealed presence of only one hooklet suggestive of T. solium cysticercus. Mitochondrial DNA analysis confirmed it to be T. solium cysticercus of Asian genotype. This is the first report on molecular typing of cysticercus isolate from ocular cysticercosis patient in India. The study suggests that the molecular analysis of cox1 gene may be a useful diagnostic tool in cases where microscopic examination is not confirmatory.

High levels of multidrug resistant tuberculosis in new and treatment-failure patients from the Revised National Tuberculosis Control Programme in an urban metropolis (Mumbai) in Western India.

PubMed

D'souza, Desiree T B; Mistry, Nerges F; Vira, Tina S; Dholakia, Yatin; Hoffner, Sven; Pasvol, Geoffrey; Nicol, Mark; Wilkinson, Robert J

2009-06-29

India, China and Russia account for more than 62% of multidrug resistant tuberculosis (MDRTB) globally. Within India, locations like urban metropolitan Mumbai with its burgeoning population and high incidence of TB are suspected to be a focus for MDRTB. However apart from sporadic surveys at watched sites in the country, there has been no systematic attempt by the Revised National Tuberculosis Control Programme (RNTCP) of India to determine the extent of MDRTB in Mumbai that could feed into national estimates. Drug susceptibility testing (DST) is not routinely performed as a part of programme policy and public health laboratory infrastructure, is limited and poorly equipped to cope with large scale testing. From April 2004 to January 2007 we determined the extent of drug resistance in 724 {493 newly diagnosed, previously untreated and 231 first line treatment failures (sputum-smear positive at the fifth month after commencement of therapy)} cases of pulmonary tuberculosis drawn from the RNTCP in four suboptimally performing municipal wards of Mumbai. The observations were obtained using a modified radiorespirometric Buddemeyer assay and validated by the Swedish Institute for Infectious Disease Control, Stockholm, a supranational reference laboratory. Data was analyzed utilizing SPSS 10.0 and Epi Info 2002. This study undertaken for the first time in RNTCP outpatients in Mumbai reveals a high proportion of MDRTB strains in both previously untreated (24%) and treatment-failure cases (41%). Amongst new cases, resistance to 3 or 4 drug combinations (amplified drug resistance) including isoniazid (H) and rifampicin (R), was greater (20%) than resistance to H and R alone (4%) at any point in time during the study. The trend for monoresistance was similar in both groups remaining highest to H and lowest to R. External quality control revealed good agreement for H and R resistance (k = 0.77 and 0.76 respectively). Levels of MDRTB are much higher in both previously untreated and first line treatment-failure cases in the selected wards in Mumbai than those projected by national estimates. The finding of amplified drug resistance suggests the presence of a well entrenched MDRTB scenario. This study suggests that a wider set of surveillance sites are needed to obtain a more realistic view of the true MDRTB rates throughout the country. This would assist in the planning of an adequate response to the diagnosis and care of MDRTB.

Role of fine needle aspiration cytology in diagnosing filarial arm cysts.

PubMed

Tandon, Nishi; Bansal, Cherry; Sharma, Richa; Irfan, Sumaiya

2013-05-17

Filariasis is prevalent in tropical and subtropical areas and is endemic in regions of India. Lymphatic filariasis in India is caused mainly by two species of nematodes: Wuchereria bancrofti and Brugia malayi, which invade the human lymphatic system. We report two cases of superficial cystic lesions of the upper limb revealed on fine needle aspiration (FNA) to be clinically unsuspected filariasis. Despite similar aetiologies, both cases revealed variations in aspirate nature, smear morphology and peripheral blood findings. FNA provides definitive diagnosis and is an important tool for diagnosing soft tissue swellings owing to filariasis.

Skills Development in the Informal Sector in India: The Case of Street Food Vendors

ERIC Educational Resources Information Center

Pilz, Matthias; Uma, Gengaiah; Venkatram, Rengan

2015-01-01

The informal sector dominates India's economic life, so issues of skills development are particularly important. On the basis of a survey of 49 street food vendors in the Indian cities of New Delhi and Coimbatore, the authors of this article demonstrate that informal learning is a particularly significant form of vocational education and training.…

The Role of Training in Reducing Poverty: The Case of Microenterprise Development in India

ERIC Educational Resources Information Center

Bharti, Nisha

2014-01-01

Self-employment in general and microenterprise in particular is evolving as a prospective option for income generation and the reduction of poverty in developing economies such as India. However, a lack of skills among the poor has been identified as one of the key hindrances in promoting microenterprises and, therefore, in reducing poverty.…

Silencing and Languaging in the Assembling of the Indian Nation-State: British Public Citizens, the Epistolary Form, and Historiography

ERIC Educational Resources Information Center

Ramanathan, Vaidehi

2009-01-01

Taking the case of postcolonial India, this paper explores ways in which present temporal junctures permit a probing of historical boundaries to speak of voices largely silenced from Indian historiography, namely those of British (Indian) public citizens who were committed to the assembling of "an India." In particular, the paper…

Healing traditions and men's sexual health in Mumbai, India: the realities of practiced medicine in urban poor communities.

PubMed

Schensul, Stephen L; Mekki-Berrada, Abdelwahed; Nastasi, Bonnie; Saggurti, Niranjan; Verma, Ravi K

2006-06-01

Men's pre- and extra-marital sexual behavior has been identified as the primary factor in the growing HIV/STI epidemic among both males and females in India. One major barrier to reaching men has been their underutilization of public health services, which has severely limited programs geared to prevention and early case identification. A significant number of men in India have strong culturally-based sexual health concerns, much of which are derived from "semen-loss" and deficiencies in sexual performance. This paper reports on an ongoing Indo-US project that has focused on men's concerns about sexual health problems and assesses the services provided by non-allopaths in three low-income communities in Mumbai. Findings indicate that the primary health resources for these men are private, community-based non-allopaths, who identify themselves as ayurvedic, unani and homeopathic providers. The paper suggests that the combination of strong culturally-based sexual health concerns and the presence of private non-allopaths who manage these problems present a window of opportunity for intervention programs to address the challenge of HIV/STI prevention and early case identification in India.

Vocational Guidance for Equal Access and Opportunity for Girls and Women in Technical and Vocational Education. UNEVOC Studies in Technical and Vocational Education 6.

ERIC Educational Resources Information Center

Miller, Juliet V.; Vetter, Louise

A study examined the relevance of vocational information and guidance for the equal access of girls and women to technical/vocational education in the following countries: Argentina; India; Mexico; Republic of Korea; South Africa; Spain; Sweden; Turkey; United Arab Emirates; and Zambia. Case studies were conducted by using a multiple-strategy…

Promoting operational research through fellowships: a case study from the South-East Asia Union Office.

PubMed

Kumar, A M V; Satyanarayana, S; Berger, S Dar; Chadha, S S; Singh, R J; Lal, P; Tonsing, J; Harries, A D

2015-03-21

In 2009, the International Union Against Tuberculosis and Lung Disease (The Union) and Médecins Sans Frontières (MSF) jointly developed a new paradigm for operational research (OR) capacity building and started a new process of appointing and supporting OR fellows in the field. This case study describes 1) the appointment of two OR fellows in The Union South-East Asia Office (USEA), New Delhi, India; 2) how this led to the development of an OR unit in that organisation; 3) achievements over the 5-year period from June 2009 to June 2014; and 4) challenges and lessons learnt. In June 2009, the first OR fellow in India was appointed on a full-time basis and the second was appointed in February 2012-both had limited previous experience in OR. From 2009 to 2014, annual research output and capacity building initiatives rose exponentially, and included 1) facilitation at 61 OR training courses/modules; 2) publication of 96 papers, several of which had a lasting impact on national policy and practice; 3) providing technical assistance in promoting OR; 4) building the capacity of medical college professionals in data management; 5) support to programme staff for disseminating their research findings; 6) reviewing 28 scientific papers for national or international peer-reviewed journals; and 7) developing 45 scientific abstracts for presentation at national and international conferences. The reasons for this success are highlighted along with ongoing challenges. This experience from India provides good evidence for promoting similar models elsewhere.

Role of the Elected Panchayat Samity Members in National Health and Family Welfare Programs: A Case Study

ERIC Educational Resources Information Center

Barman, Subhash

2009-01-01

The geographical area of this study is West Bengal--a constituent state (province) of India. The state government policy aims at administrative decentralization through Panchayats (or Village Councils) in rural areas. It is a 3-tier system, comprising a Gram Panchayat in every village, Panchayat Samity (block level), and Zilla Parishad (district…

Measuring Effectiveness of Information, Communication and Technology (ICT) Tools in Teaching School Children: A Case Study from Chattisgarh State, India

ERIC Educational Resources Information Center

Rao, J. Durga Prasad; Singh, Raksha

2011-01-01

The study was conducted to determine the effectiveness of Information Communication and Technology tools viz DLP (Distance Learning Projector) and Computer/Laptop in comparison with selected instructional media for teaching primary and secondary school pupils. It examined the effect of grade on the performance of the pupils taught with four…

Experiencing abortion rights in India through issues of autonomy and legality: A few controversies.

PubMed

Patel, Tulsi

2018-06-01

Abortion laws in India, like other laws, are premised on the 1861 British Penal Code. The Medical Termination of Pregnancy Act was passed in 1971 to circumvent the criminality clause around abortion. Yet the law continues to render invisible women's right to choose. Legal procedures have often hindered in permitting abortion, resulting in the death of a mother or the foetus. Despite the latest techno-medical advances, the laws have remained stagnant or rather restrictive, complicated further by selective female foetus abortions. Legal resistance to abortion-seeking after 20 weeks gestation adversely affects women, depriving them of autonomy of choice. In this paper, raising important gender, health and ethical issues are illustrated through a recent legal case in India. Feminist campaigns against the legal mindset in India are emerging.

Achieving Millennium Development Goals 4 and 5: a snapshot of life in rural India.

PubMed

Mullick, S S; Serle, E

2011-09-01

The case studies presented here illustrate the poignant reality of life for mothers and children in rural India. We highlight the challenges of achieving millennium development goals (MDGs) 4 and 5, by exploring the reasons behind maternal and childhood mortality using the three-delays model as a framework. Gender disparities, lack of empowerment of women, poor understanding of life-threatening illness, the inability to know when and where to seek help, security issues, deficiencies in understanding cultural perceptions, poorly equipped health facilities and a lack of skilled personnel are all highlighted. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

Invariant features of spatial inequality in consumption: The case of India

NASA Astrophysics Data System (ADS)

Chatterjee, Arnab; Chakrabarti, Anindya S.; Ghosh, Asim; Chakraborti, Anirban; Nandi, Tushar K.

2016-01-01

We study the distributional features and inequality of consumption expenditure across India, for different states, castes, religion and urban-rural divide. We find that even though the aggregate measures of inequality are fairly diversified across states, the consumption distributions show near identical statistics, once properly normalized. This feature is seen to be robust with respect to variations in sociological and economic factors. We also show that state-wise inequality seems to be positively correlated with growth which is in accord with the traditional idea of Kuznets' curve. We present a brief model to account for the invariance found empirically and show that better but riskier technology draws can create a positive correlation between inequality and growth.

Does quality of drinking water matter in kidney stone disease: A study in West Bengal, India.

PubMed

Mitra, Pubali; Pal, Dilip Kumar; Das, Madhusudan

2018-05-01

The combined interaction of epidemiology, environmental exposure, dietary habits, and genetic factors causes kidney stone disease (KSD), a common public health problem worldwide. Because a high water intake (>3 L daily) is widely recommended by physicians to prevent KSD, the present study evaluated whether the quantity of water that people consume daily is associated with KSD and whether the quality of drinking water has any effect on disease prevalence. Information regarding residential address, daily volume of water consumption, and source of drinking water was collected from 1,266 patients with kidney stones in West Bengal, India. Drinking water was collected by use of proper methods from case (high stone prevalence) and control (zero stone prevalence) areas thrice yearly. Water samples were analyzed for pH, alkalinity, hardness, total dissolved solutes, electrical conductivity, and salinity. Average values of the studied parameters were compared to determine if there were any statistically significant differences between the case and control areas. We observed that as many as 53.6% of the patients consumed <3 L of water daily. Analysis of drinking water samples from case and control areas, however, did not show any statistically significant alterations in the studied parameters. All water samples were found to be suitable for consumption. It is not the quality of water, rather the quantity of water consumed that matters most in the occurrence of KSD.

Study of environmental and genetic factors in children with craniosynostosis: A case-control study

PubMed Central

Barik, Mayadhar; Bajpai, Minu; Das, Rashmi Ranjan; Panda, Shasanka Shekhar

2013-01-01

Background: Craniosynostosis is a congenital defect that causes one or more sutures on an infant's skull to close earlier than normal. Though both genetic and environmental factors play a role in its pathogenesis, there is no published Indian data to verify this. Materials and Methods: In this case-control study, we investigated the association of craniosynostosis with parental age in 50 children with craniosynostosis attending the surgical outpatient department of a tertiary care institution in North India. Results: There was a significant association of craniosynostosis with advanced parental [OR 2.17 (95% CI 1.08 to 4.36)] but not maternal age. Education status of parents also revealed that those having a higher education had an increased risk of having a child with craniosynostosis [maternal education, OR 2.32 (95% CI 1.2 to 4.76); paternal education, OR 2.51 (95% CI 1.21 to 5.0)]. Molecular analysis by sequencing confirmed following amino-acid substitution in different Exons of the FGFR2 gene. Besides these, we found other novel identical mutations in FGFR2 gene in both syndromic and non-syndromic craniosynostoses. Conclusion: This is the first epidemiological study in India that provides evidence that, advanced paternal age and higher parental education level might be associated with an increased risk of craniosynostosis. New mutations were identified in cases of both syndromic and non-syndromic craniosynostosis. PMID:24082921

Study of environmental and genetic factors in children with craniosynostosis: A case-control study.

PubMed

Barik, Mayadhar; Bajpai, Minu; Das, Rashmi Ranjan; Panda, Shasanka Shekhar

2013-05-01

Craniosynostosis is a congenital defect that causes one or more sutures on an infant's skull to close earlier than normal. Though both genetic and environmental factors play a role in its pathogenesis, there is no published Indian data to verify this. In this case-control study, we investigated the association of craniosynostosis with parental age in 50 children with craniosynostosis attending the surgical outpatient department of a tertiary care institution in North India. There was a significant association of craniosynostosis with advanced parental [OR 2.17 (95% CI 1.08 to 4.36)] but not maternal age. Education status of parents also revealed that those having a higher education had an increased risk of having a child with craniosynostosis [maternal education, OR 2.32 (95% CI 1.2 to 4.76); paternal education, OR 2.51 (95% CI 1.21 to 5.0)]. Molecular analysis by sequencing confirmed following amino-acid substitution in different Exons of the FGFR2 gene. Besides these, we found other novel identical mutations in FGFR2 gene in both syndromic and non-syndromic craniosynostoses. This is the first epidemiological study in India that provides evidence that, advanced paternal age and higher parental education level might be associated with an increased risk of craniosynostosis. New mutations were identified in cases of both syndromic and non-syndromic craniosynostosis.

A study on economic power dispatch grid connected PV power plant in educational institutes

NASA Astrophysics Data System (ADS)

Singh, Kuldip; Kumar, M. Narendra; Mishra, Satyasis

2018-04-01

India has main concerns on environment and escalation of fuel prices with respect to diminution of fossil fuel reserves and the major focus on renewable Energy sources for power generation to fulfill the present and future energy demand. Installation of PV power plants in the Educational Institutions has grown up drastically throughout India. More PV power plant are integrated with load and grid through net metering. Therefore, this paper is an analysis of the 75kWp PV plant at chosen buses, considering the need of minimum demand from the grid. The case study is carried out for different generation level throughout the day and year w.r.t load and climate changes, load sharing on grid. The economic dispatch model developed for PV plant integrated with Grid.

Prevalence and Associated Factors of Alcoholism among Tuberculosis Patients in Udupi Taluk, Karnataka, India: A Cross Sectional Study.

PubMed

Thapa, P; Kamath, R; Shetty, B K; Monteiro, A; Sekaran, V C

2014-01-01

Tuberculosis (TB) is a major public health problem in India. Several studies carried out in India have shown alcoholism as a risk factor for tuberculosis mortality, factor for default in TB and reason for non-compliance under the Revised National Tuberculosis Control Program (RNTCP). The aim of this study was to assess the prevalence, pattern and associated factors of alcohol use among tuberculosis patients in Udupi taluk, Karnataka, India. A cross-sectional study was conducted with the complete enumeration of all the cases undergoing Directly Observed Treatment Short-course (DOTS) treatment in Primary Health Centre and Community Health Centre of Udupi taluk from March to April 2013. Interview was conducted to obtain the socio-demographic and health information and participants were screened using WHO developed Alcohol Use Disorders Identification Test (AUDIT) for alcohol use. Out of 123 participants, 78% were males, 86.2% were Hindu, 79.7% were married and 88.6% were from low socio-economic status. About 20.3% (n=25) participants were alcoholic. Among them, 44% were low risk drinkers, 32% were hazardous drinkers, 4% were harmful drinkers and 20% were alcohol dependent. Age, sex, occupation, tobacco use, perceived health status and discrimination due to tuberculosis positive status were significantly associated with alcohol use. On logistic regression sex, tobacco use, perceived health status and facing discrimination due infection with tuberculosis were found to be factors associated with alcohol use. This study found a high prevalence of alcoholism among tuberculosis patients which is of concern and has to be addressed.

Interrupting wild poliovirus transmission using oral poliovirus vaccine: environmental surveillance in high-risks area of India.

PubMed

Chowdhary, Rashmi; Dhole, T N

2008-08-01

Global eradication of poliomyelitis has reached critical stage. Sabin Oral Poliovirus Vaccine (OPV) has been successful in three major regions of the world. In India eradication of poliomyelitis from states of Uttar Pradesh (UP) and Bihar has been difficult due to high population and low-socioeconomic standards of living. Acute flaccid paralysis (AFP) surveillance and intensive OPV rounds continues with the World Health Organization (WHO) operational strategies. Yet apparent lack of progress in reducing the number of wild cases has resulted in occasional impatience and frustration, even leading to questions about ultimate feasibility of global eradication using OPV. Lucknow in UP is in geographical area endemic for poliomyelitis and is surrounded by high-risk areas yet maintains a polio-free status since 2002. Environmental surveillance study was conducted (2004-2006) to authenticate the decline in the wild poliovirus (PV) cases in Lucknow. Sewage sample analyses were compared with stools of AFP patients and healthy children from same geographical area. Study reveals useful information on OPV circulation and proves important epidemiological tool to trust WHO's OPV immunization program. Genetic sequencing had detected silent wild PV-1 circulation of RCP1PGI (EU049849), RCP2PGI (EU049850), RCP3PGI (EU049851), and RCP4PGI (EU049852) in sewage waters. Properties of isolates from sewage reflected those of viruses excreted from human. This study provides valuable information and encouragement to AFP surveillance to maintain high levels of OPV immunization campaigns in the most difficult endemic region of India to interrupt the wild PV transmission.

Survey of patient dosimetry for head and neck cancer patients undergoing external radiotherapy treatment: a study from northeastern hospitals of India.

PubMed

Sharma, Arunkumar B; Singh, Tomcha Th; Singh, Khelendra N; Gartia, R K

2009-01-01

To study dosimetry of patients during the external radiotherapy of head and neck cancers from different hospitals of the northeastern region (NER) of India. 35 confirmed cases of head and neck cancers reporting to three different hospitals in the NER of India who underwent radiation treatment were the materials for the study. Dosimetry was carried out at 8(eight) anatomical points to these patients, namely, target (entrance and exit points), forehead, chest, abdomen, gonad, arm, and leg respectively by thermoluminescence (TL) as well as optically stimulated luminescence (OSL) dosimeters. Unlike conventional appliances, we used common iodized salt as TL/OSL phosphor. Patient dosimetry was found to vary with an average of 1.17 +/- 0.39 Sv at forehead, 1.24 +/- 0.39 Sv at chest, 0.52 +/- 0.13 Sv at gonad to a minimum of 0.26 +/- 0.07 Sv at leg areas when exposed to a cumulative dose of 65 Sv at the target. Maximum dose received from a stray radiation is about 1.5 Sv at forehead/chest and dosimetry of patient among the three centers is not significantly different at the 5% level of probability.

Gorlin-goltz syndrome.

PubMed

Mehta, Dn; Raval, N; Patadiya, H; Tarsariya, V

2014-03-01

The Gorlin-Goltz syndrome (GGS) (the nevoid basal cell carcinoma syndrome) is a rare autosomal dominant syndrome caused due to mutations in the patched gene found on chromosome arm 9 q. It shows high penetrance and variable expressivity; is characterized by basal cell carcinomas, odontogenic keratocysts, palmar and/or plantar pits and ectopic calcifications of the falx cerebri. Until date, very few cases of GGS have been reported in India. Early diagnosis and treatment as well as genetic counseling are essential for this syndrome. A rare case report of a patient with characteristic features of GGS diagnosed at a rural dental college of Gujarat, India is presented here. This case report draws attention of the valuable role of dentist in diagnosis and early management of this syndrome.

Gorlin-Goltz Syndrome

PubMed Central

Mehta, DN; Raval, N; Patadiya, H; Tarsariya, V

2014-01-01

The Gorlin-Goltz syndrome (GGS) (the nevoid basal cell carcinoma syndrome) is a rare autosomal dominant syndrome caused due to mutations in the patched gene found on chromosome arm 9 q. It shows high penetrance and variable expressivity; is characterized by basal cell carcinomas, odontogenic keratocysts, palmar and/or plantar pits and ectopic calcifications of the falx cerebri. Until date, very few cases of GGS have been reported in India. Early diagnosis and treatment as well as genetic counseling are essential for this syndrome. A rare case report of a patient with characteristic features of GGS diagnosed at a rural dental college of Gujarat, India is presented here. This case report draws attention of the valuable role of dentist in diagnosis and early management of this syndrome. PMID:24761254

HMB-45 negative multifocal malignant perivascular epithelioid cell tumor of the soft tissue responding to sirolimus: First case report from India.

PubMed

Kapoor, Akhil; Beniwal, Surender; Singhal, Mukesh Kumar; Kumar, Narender; Kumar, Vanita; Kumar, Harvindra Singh

2015-01-01

Perivascular epithelioid cell tumor (PEComa) is a group of sarcomas that exhibit a myomelanocytic phenotype and possess a unique cell type in the perivascular epithelioid cell. Traditionally HMB-45 immunoreactivity is the first criteria required to consider a tumor to be PEComa. We report a case of multifocal PEComa with negative HMB-45 marker. The patient presented with three big ulceroproliferative lesions; two over right thigh and one over the scalp in the right frontal region. The patient was prescribed with oral sirolimus to which good response was seen. To the best of our knowledge, this is the first case of HMB-45 negative multifocal malignant PEComa from India.

Indoor air pollution and its association with poor lung function, microalbuminuria and variations in blood pressure among kitchen workers in India: a cross-sectional study.

PubMed

Singh, Amarnath; Kesavachandran, Chandrasekharan Nair; Kamal, Ritul; Bihari, Vipin; Ansari, Afzal; Azeez, Parappurath Abdul; Saxena, Prem Narain; Ks, Anil Kumar; Khan, Altaf Hussain

2017-04-04

The present study is an attempt to explore the association between kitchen indoor air pollutants and physiological profiles in kitchen workers with microalbuminuria (MAU) in north India (Lucknow) and south India (Coimbatore). The subjects comprised 145 control subjects, 233 kitchen workers from north India and 186 kitchen workers from south India. Information related to the personal and occupational history and health of the subjects at both locations were collected using a custom-made questionnaire. Worker lung function was measured using a spirometer. Blood pressure was monitored using a sphygmomanometer. Urinary MAU was measured using a urine analyzer. Indoor air monitoring in kitchens for particulate matter (PM), total volatile organic compounds (TVOC), carbon dioxide (CO 2 ) and carbon monoxide (CO) was conducted using indoor air quality monitors. The size and shape of PM in indoor air was assessed using a scanning electron microscope (SEM). Fourier transform infrared (FTIR) spectroscopy was used to detect organic or inorganic compounds in the air samples. Particulate matter concentrations (PM 2.5 and PM 1 ) were significantly higher in both north and south Indian kitchens than in non-kitchen areas. The concentrations of TVOC, CO and CO 2 were higher in the kitchens of north and south India than in the control locations (non-kitchen areas). Coarse, fine and ultrafine particles and several elements were also detected in kitchens in both locations by SEM and elemental analysis. The FTIR spectra of kitchen indoor air at both locations show the presence of organic chemicals. Significant declines in systolic blood pressure and lung function were observed in the kitchen workers with MAU at both locations compared to those of the control subjects. A higher prevalence of obstruction cases with MAU was observed among the workers in the southern region than in the controls (p < 0.01). Kitchen workers in south India have lower lung capacities and a greater risk of obstructive and restrictive abnormalities than their north Indian counterparts. The study showed that occupational exposure to multiple kitchen indoor air pollutants (ultrafine particles, PM 2.5 , PM 1 , TVOC, CO, CO 2 ) and FTIR-derived compounds can be associated with a decline in lung function (restrictive and obstructive patterns) in kitchen workers with microalbuminuria. Further studies in different geographical locations in India among kitchen workers on a wider scale are required to validate the present findings.

Clinical and molecular epidemiology of beta-hemolytic streptococcal infections in India.

PubMed

Mathur, Purva; Bhardwaj, Nidhi; Mathur, Kushal; Behera, Bijayini; Gupta, Gunjan; Kapil, Arti; Singh, Sarman; Misra, Mahesh Chandra

2014-03-13

Beta-hemolytic streptococci (βHS) cause a diverse array of human infections. Despite the high number of cases of streptococcal carriers and diseases, studies discerning the molecular epidemiology of βHS in India are limited. This study reports the molecular and clinical epidemiology of beta-hemolytic streptococcal infections from two geographically distinct regions of India. A total of 186 isolates of βHS from north and south India were included. The isolates were identified to species level and subjected to antimicrobial susceptibility testing. Polymerase chain reaction (PCR) was done to detect exotoxin genes, and emm types of group A streptococci (GAS) strains were ascertained by sequencing. GAS was the most common isolate (71.5%), followed by group G streptococci (GGS) (21%). A large proportion of GAS produced speB (97%), smeZ (89%), speF (91%), and speG (84%). SmeZ was produced by 21% and 50% of GGS and GGS, respectively. A total of 45 different emm types/subtypes were seen in GAS, with emm 11 being the most common. Resistance to tetracycline (73%) and erythromycin (34.5%) was commonly seen in GAS. A high diversity of emm types was seen in Indian GAS isolates with high macrolide and tetracycline resistance. SpeA was less commonly seen in Indian GAS isolates. There was no association between disease severity and exotoxin gene production.

A Nonlinear Inversion Approach to Map the Magnetic Basement: A Case Study from Central India Using Aeromagnetic Data

NASA Astrophysics Data System (ADS)

Kumar, R.; Bansal, A. R.; Anand, S. P.; Rao, V. K.; Singh, U. K.

2016-12-01

The central India region is having complex geology covering various geological units e.g., Precambrian Bastar Craton (including Proterozoic Chhattisgarh Basin, granitic intrusions etc.) and Eastern Ghat Mobile Belt, Gondwana Godavari and Mahanadi Grabens, Late Cretaceous Deccan Traps etc. The central India is well covered by reconnaissance scale aeromagnetic data. We analyzed this data for mapping the basement by dividing into143 overlapping blocks of 100×100km using least square nonlinear inversion method for fractal distribution of sources. The scaling exponents and depth values are optimized using grid search method. We interpreted estimated depths of anomalous sources as magnetic basement and shallow anomalous magnetic sources. The shallow magnetic anomalies are found to vary from 1 to 3km whereas magnetic basement depths are found to vary from 2km to 7km. The shallowest basement depth of 2km found corresponding to Kanker granites a part of Bastar Craton whereas deepest basement depth of 7km is associated with Godavari Graben and south eastern part of Eastern Ghat Mobile Belts near the Parvatipuram Bobbili fault. The variation of magnetic basement, shallow depths and scaling exponent in the region indicate complex tectonic, heterogeneity and intrusive bodies at different depths which is due to different tectonic processes in the region. The detailed basement depth of central India is presented in this study.

Role of bronchoscopy in evaluation of cases with sputum smear negative pulmonary tuberculosis, interstitial lung disease and lung malignancy: A retrospective study of 712 cases.

PubMed

Kumar, Raj; Gupta, Nitesh

2015-01-01

The introduction of flexible bronchoscope has revolutionized the field of pulmonary medicine and is a standard instrument used for diagnostic purpose. A retrospective analysis of the clinico-radiological profile, indication, biopsy procedure and complications, for patients undergoing bronchoscopy at one of the respiratory unit at a tertiary care center in India. Retrospective analysis of 712 bronchoscopies was done in regard to demographic profile, clinical and radiological presentation and diagnostic indication. The results were analyzed on basis of bronchoscopy inspection and histopathological specimen obtained from transbronchial (TBLB), endobronchial biopsy (EBLB) and cytology specimen by transbronchial needle aspiration (TBNA). Furthermore, diagnostic yield of each biopsy procedure and their combination was evaluated. Of 712 patients undergoing bronchoscopy, the pathological diagnosis was achieved in 384 (53.93%). Of 384 diagnosed cases, the clinic-radio-pathological diagnosis of pulmonary tuberculosis in 88 (22.19%), interstitial lung disease (ILDs) in 226 (58.85%), and lung cancer in 70 (18.22%) cases. Of 116 sputum smear negative tuberculosis patients, 88 (75.86%) were diagnosed to be pulmonary tuberculosis; the contribution of BAL being 71.59%. Of 226 ILDs, sarcoidosis was most common 148/226 (65.48%). Among 70 lung cancer diagnosed cases, squamous cell carcinoma was most common (54.28%). The results from current study reemphasizes on the diagnostic utility as well as safety of the bronchoscopy procedure. Copyright © 2015 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Risk Factors Associated with MDR-TB at the Onset of Therapy among New Cases Registered with the RNTCP in Mumbai, India

PubMed Central

Atre, Sachin R.; D’Souza, Desiree T. B.; Vira, Tina S.; Chatterjee, Anirvan; Mistry, Nerges F.

2014-01-01

Background Multidrug-resistant TB (MDR-TB) has emerged as a major threat to global TB control efforts in recent years. Facilities for its diagnosis and treatment are limited in many high-burden countries, including India. In hyper-endemic areas like Mumbai, screening for newly diagnosed cases at a higher risk of acquiring MDR-TB is necessary, for initiating appropriate and timely treatment, to prevent its further spread. Objective To assess risk factors associated with MDR-TB among Category I, new sputum smear-positive cases, at the onset of therapy. Materials and Methods The study applied an unmatched case-control design for 514 patients (106 cases with MDR-TB strains and 408 controls with non-MDR-TB strains). The patients were registered with the Revised National Tuberculosis Control Program (RNTCP) in four selected wards of Mumbai during April 2004-January 2007. Data were collected through semi-structured interviews and drug susceptibility test results. Results Multivariate analysis indicated that infection with the Beijing strain (OR = 3.06; 95% C.I. = 1.12-8.38; P = 0.029) and female gender (OR = 1.68; 95% C.I. = 1.02-2.87; P = 0.042) were significant predictors of MDR-TB at the onset of therapy. Conclusion The study provides a starting point to further examine the usefulness of these risk factors as screening tools in identifying individuals with MDR-TB, in settings where diagnostic and treatment facilities for MDR-TB are limited. PMID:21727675

Substance abuse as a way of life in marginalized gender identity disorder: a case report with review of Indian literature.

PubMed

Goyal, Shrigopal; Deb, Koushik Sinha; Elawadhi, Deeksha; Kaw, Nanaji

2014-12-01

Persons suffering from gender identity disorder (GID) are often severely marginalized in India and mostly live outside the society as a part of a minority community called the Hijras. Although substance abuse is considered a way of life in them, such patients rarely seek treatment because of the stigma and fear of discrimination. We report a case of GID presenting to tertiary care centre for treatment of multiple substance use dependence (SUD). The case is the first to highlight the use and dependence of multiple substances in the Hijra community of India. Further, the case emphasizes that SUD treatment might be a worthwhile intervention to bring such marginalized population under treatment, when further complicated issues on gender identity can be addressed. Copyright © 2014. Published by Elsevier B.V.

Genetic analysis in Bartter syndrome from India.

PubMed

Sharma, Pradeep Kumar; Saikia, Bhaskar; Sharma, Rachna; Ankur, Kumar; Khilnani, Praveen; Aggarwal, Vinay Kumar; Cheong, Hae

2014-10-01

Bartter syndrome is a group of inherited, salt-losing tubulopathies presenting as hypokalemic metabolic alkalosis with normotensive hyperreninemia and hyperaldosteronism. Around 150 cases have been reported in literature till now. Mutations leading to salt losing tubulopathies are not routinely tested in Indian population. The authors have done the genetic analysis for the first time in the Bartter syndrome on two cases from India. First case was antenatal Bartter syndrome presenting with massive polyuria and hyperkalemia. Mutational analysis revealed compound heterozygous mutations in KCNJ1(ROMK) gene [p(Leu220Phe), p(Thr191Pro)]. Second case had a phenotypic presentation of classical Bartter syndrome however, genetic analysis revealed only heterozygous novel mutation in SLC12A gene p(Ala232Thr). Bartter syndrome is a clinical diagnosis and genetic analysis is recommended for prognostication and genetic counseling.

Poliomyelitis surveillance: the model used in India for polio eradication.

PubMed Central

Banerjee, K.; Hlady, W. G.; Andrus, J. K.; Sarkar, S.; Fitzsimmons, J.; Abeykoon, P.

2000-01-01

Poliomyelitis surveillance in India previously involved the passive reporting of clinically suspected cases. The capacity for detecting the disease was limited because there was no surveillance of acute flaccid paralysis (AFP). In October 1997, 59 specially trained Surveillance Medical Officers were deployed throughout the country to establish active AFP surveillance; 11,533 units were created to report weekly on the occurrence of AFP cases at the district, state and national levels; timely case investigation and the collection of stool specimens from AFP cases was undertaken; linkages were made to support the polio laboratory network; and extensive training of government counterparts of the Surveillance Medical Officers was conducted. Data reported at the national level are analysed and distributed weekly. Annualized rates of non-polio AFP increased from 0.22 per 100,000 children aged under 15 years in 1997 to 1.39 per 100,000 in 1999. The proportion of cases with two adequate stools collected within two weeks of the onset of paralysis increased from 34% in 1997 to 68% in 1999. The number of polio cases associated with the isolation of wild poliovirus decreased from 211 in the first quarter of 1998 to 77 in the first quarter of 1999. Widespread transmission of wild poliovirus types 1 and 3 persists throughout the country; type 2 occurs only in Bihar and Uttar Pradesh. In order to achieve polio eradication in India during 2000, extra national immunization days and house-to-house mopping-up rounds should be organized. PMID:10812728

Duchenne Muscular Dystrophy and Becker Muscular Dystrophy Confirmed by Multiplex Ligation-Dependent Probe Amplification: Genotype-Phenotype Correlation in a Large Cohort.

PubMed

Vengalil, Seena; Preethish-Kumar, Veeramani; Polavarapu, Kiran; Mahadevappa, Manjunath; Sekar, Deepha; Purushottam, Meera; Thomas, Priya Treesa; Nashi, Saraswathi; Nalini, Atchayaram

2017-01-01

Studies of cases of Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) confirmed by multiplex ligation-dependent probe amplification (MLPA) have determined the clinical characteristics, genotype, and relations between the reading frame and phenotype for different countries. This is the first such study from India. A retrospective genotype-phenotype analysis of 317 MLPA-confirmed patients with DMD or BMD who visited the neuromuscular clinic of a quaternary referral center in southern India. The 317 patients comprised 279 cases of DMD (88%), 32 of BMD (10.1%), and 6 of intermediate phenotype (1.9%). Deletions accounted for 91.8% of cases, with duplications causing the remaining 8.2%. There were 254 cases of DMD (91%) with deletions and 25 (9%) due to duplications, and 31 cases (96.8%) of BMD with deletions and 1 (3.2%) due to duplication. All six cases of intermediate type were due to deletions. The most-common mutation was a single-exon deletion. Deletions of six or fewer exons constituted 68.8% of cases. The deletion of exon 50 was the most common. The reading-frame rule held in 90% of DMD and 94% of BMD cases. A tendency toward a lower IQ and earlier wheelchair dependence was observed with distal exon deletions, though a significant correlation was not found. The reading-frame rule held in 90% to 94% of children, which is consistent with reports from other parts of the world. However, testing by MLPA is a limitation, and advanced sequencing methods including analysis of the structure of mutant dystrophin is needed for more-accurate assessments of the genotype-phenotype correlation.

Emergence of the Asian genotype of DENV-1 in South India.

PubMed

Cecilia, D; Patil, J A; Kakade, M B; Walimbe, A; Alagarasu, K; Anukumar, B; Abraham, A

2017-10-01

A large outbreak of dengue occurred in Tamil Nadu, South India in 2012 with 12,000 cases and CFR of 0.5%. Molecular characterization of virus present in the sera of dengue patients was undertaken to determine if there were changes in the virus population. All four serotypes were circulating but DENV-1 was dominant, present in 52% of the serotyped samples. Furthermore, the genotype of only DENV-1 had changed; the Asian genotype had displaced the American/African. Phylogenetic analysis revealed that the Asian genotype was introduced from Singapore and shared 99% similarity with viruses, associated with large outbreaks in Singapore and Sri Lanka. We report for the first time the emergence of the Asian genotype of DENV-1 in southern India causing an extensive and severe outbreak. The study proves how movement of DENV can affect dengue outbreaks and underscores the need for close molecular monitoring of DENV. Copyright © 2017 Elsevier Inc. All rights reserved.

Isolation of Cryptococcus neoformans var. gattii from Eucalyptus camaldulensis in India.

PubMed Central

Chakrabarti, A; Jatana, M; Kumar, P; Chatha, L; Kaushal, A; Padhye, A A

1997-01-01

Cryptococcus neoformans var. gattii has an ecological association with five Eucalyptus species: E. blakelyi, E. camaldulensis, E. gomphocephala, E. rudis, and E. tereticornis. After human infections due to C. neoformans var. gattii were diagnosed in the states of Punjab, Himachal Pradesh, and Karnataka, India, a study was undertaken to investigate the association of C. neoformans var. gattii with Indian eucalypts, especially in the state of Punjab. A total of 696 specimens collected from E. camaldulensis, E. citriodora and E. tereticornis (hybrid) trees were examined for the presence of C. neoformans var. gattii. Flowers from two trees of E. camaldulensis in the Chak Sarkar forest and one from the village of Periana near the Ferozepur area yielded five isolates of C. neoformans var. gattii. The origin of the trees could be traced to Australia, thus providing evidence that the distribution of E. camaldulensis correlated with the distribution of human cryptococcosis cases caused by C. neoformans var. gattii in northern India. PMID:9399553

Measles control strategies in India: position paper of Indian Academy of Pediatrics.

PubMed

Vashishtha, V M; Choudhury, P; Bansal, C P; Gupta, S G

2013-06-08

Measles continues to be a major cause of childhood morbidity and mortality in India. Recent studies estimate that 80,000 Indian children die each year due to measles and its complications, amounting to 4% of under-5 deaths. Immunization against measles directly contributes to the reduction of under five child mortality and hence to the achievement of Millennium Development Goal 4 (MDG 4). The live attenuated measles vaccines are safe, effective and provide long lasting protection. The key strategies being followed globally for measles mortality reduction are high coverage of measles first dose, sensitive laboratory supported surveillance, appropriate case management, and providing second dose of measles vaccine. Prior to 2010, India was the only country in the world that had not introduced a second dose of measles vaccine in its National immunization program. We herein discuss the current status of measles vaccination along with the rationale and challenges of providing a second opportunity for measles vaccination, and the principles of measles catch-up campaigns.

Social Capital as the Catalyst for School Participation

ERIC Educational Resources Information Center

Iyengar, Radhika

2012-01-01

This article investigates the association between social capital and education in Jhabua, a tribal dominated district of central India. The case study analysis showed a disconnection between social capital and education in the majority of the villages. However, two of the fourteen villages showed that empowerment of the civil society made formal…

Technology and Modernity at the Boundaries of Global Delhi

ERIC Educational Resources Information Center

Sarkar, Sreela

2013-01-01

This dissertation studies the promise of inclusion in the global information society for marginalized groups in India, a nation that represents a modular case for technology and modernization initiatives in the global South. There has been significant research on the problematic notion of the "digital divide," based on the premise that…

Problems of Accreditation and Quality Assurance of Engineering Education in Developing Countries.

ERIC Educational Resources Information Center

Bordia, Surek

2001-01-01

Discusses the relationship between funding, management, and quality assurance in engineering education in developing countries. Presents a few case studies on problems of accreditation and quality assessment in larger developing countries such as India and the Philippines, and also in very small developing countries such as Papua New Guinea, Fiji,…

Micro-Level Educational Planning and Management. Case Studies from India.

ERIC Educational Resources Information Center

Bhushan, Satya; And Others

In the Fifth Five Year Plan, the Indian Planning Commission recommended "democratic decentralization" to help remove disparities at the local level. Priorities were to be adult literacy and universal elementary education, with emphasis on adopting a multilevel approach to educational planning. The idea was to provide action plans at the…

Technology Enhanced Learning: A Case Study of NPTEL

ERIC Educational Resources Information Center

Nitonde, Rohidas

2018-01-01

Technology Enhanced Learning (TEL) is a major 21st century trend in Higher Education. There are several government initiatives in India towards e-learning. National Programme on Technology Enhanced Learning (NPTEL) is one of the major initiatives. The present paper is an assessment of various aspects of this programme. It aims at evaluating the…

Etiology of Fever of Unknown Origin in Children from Mumbai, India.

PubMed

Landge, Amruta Avinash; Singhal, Tanu

2018-01-15

This descriptive study evaluated 49 children with fever lasting for more than 7 days at a tertiary hospital in urban Mumbai. Etiologic diagnosis could be established in 88% of the cases. Infections were the causein 34 (79%)patients, 6 (14%) were diagnosed as collagen vascular diseases, and 3 (7%) had other cause.

Drug resistance patterns in Mycobacterium leprae isolates from relapsed leprosy patients attending The Leprosy Mission (TLM) Hospitals in India.

PubMed

Lavania, Mallika; Jadhav, Rupendra S; Chaitanya, Vedithi Sundeep; Turankar, Ravindra; Selvasekhar, Abraham; Das, Loretta; Darlong, Famkima; Hambroom, Ujjwal K; Kumar, Sandip; Sengupta, Utpal

2014-09-01

Implementation of multidrug therapy (MDT) in leprosy control programmes has significantly reduced the global prevalence of the disease in the last two decades. After many years of use of MDT, it is expected that drug resistance in Mycobacterium leprae may emerge. This is a major concern, especially during the stage of elimination. In the present study, slit-skin smears were collected from 140 leprosy relapse cases from different Leprosy Mission hospitals across India. DNA extracted from 111 (79%) of these samples was analysed for the genes associated with drug resistance in M. leprae. More than 90% of the patients relapsed as multibacillary (MB) cases. In our study, four (3.6%) of the DNA samples analysed showed mutations associated with rifampicin resistance. We also observed that mutations associated with resistance to dapsone and ofloxacin were observed in 9 (8.1%) of the DNA samples each; two samples had both dapsone and ofloxacin resistance. Further surveillance and appropriate interventions are needed to ensure the continued success of chemotherapy for leprosy.

Maternal health in Gujarat, India: a case study.

PubMed

Mavalankar, Dileep V; Vora, Kranti S; Ramani, K V; Raman, Parvathy; Sharma, Bharati; Upadhyaya, Mudita

2009-04-01

Gujarat state of India has come a long way in improving the health indicators since independence, but progress in reducing maternal mortality has been slow and largely unmeasured or documented. This case study identified several challenges for reducing the maternal mortality ratio, including lack of the managerial capacity, shortage of skilled human resources, non-availability of blood in rural areas, and infrastructural and supply bottlenecks. The Gujarat Government has taken several initiatives to improve maternal health services, such as partnership with private obstetricians to provide delivery care to poor women, a relatively-short training of medical officers and nurses to provide emergency obstetric care (EmOC), and an improved emergency transport system. However, several challenges still remain. Recommendations are made for expanding the management capacity for maternal health, operationalization of health facilities, and ensuring EmOC on 24/7 (24 hours a day, seven days a week) basis by posting nurse-midwives and trained medical officers for skilled care, ensuring availability of blood, and improving the registration and auditing of all maternal deaths. However, all these interventions can only take place if there are substantially-increased political will and social awareness.

Enhancing TB case detection: experience in offering upfront Xpert MTB/RIF testing to pediatric presumptive TB and DR TB cases for early rapid diagnosis of drug sensitive and drug resistant TB.

PubMed

Raizada, Neeraj; Sachdeva, Kuldeep Singh; Nair, Sreenivas Achuthan; Kulsange, Shubhangi; Gupta, Radhey Shayam; Thakur, Rahul; Parmar, Malik; Gray, Christen; Ramachandran, Ranjani; Vadera, Bhavin; Ekka, Shobha; Dhawan, Shikha; Babre, Ameet; Ghedia, Mayank; Alavadi, Umesh; Dewan, Puneet; Khetrapal, Mini; Khanna, Ashwini; Boehme, Catharina; Paramsivan, Chinnambedu Nainarappan

2014-01-01

Diagnosis of pulmonary tuberculosis (PTB) in children is challenging due to difficulties in obtaining good quality sputum specimens as well as the paucibacillary nature of disease. Globally a large proportion of pediatric tuberculosis (TB) cases are diagnosed based only on clinical findings. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents the results from pediatric groups taking part in a large demonstration study wherein Xpert MTB/RIF testing replaced smear microscopy for all presumptive PTB cases in public health facilities across India. The study covered a population of 8.8 million across 18 programmatic sub-district level tuberculosis units (TU), with one Xpert MTB/RIF platform established at each study TU. Pediatric presumptive PTB cases (both TB and Drug Resistant TB (DR-TB)) accessing any public health facilities in study area were prospectively enrolled and tested on Xpert MTB/RIF following a standardized diagnostic algorithm. 4,600 pediatric presumptive pulmonary TB cases were enrolled. 590 (12.8%, CI 11.8-13.8) pediatric PTB were diagnosed. Overall 10.4% (CI 9.5-11.2) of presumptive PTB cases had positive results by Xpert MTB/RIF, compared with 4.8% (CI 4.2-5.4) who had smear-positive results. Upfront Xpert MTB/RIF testing of presumptive PTB and presumptive DR-TB cases resulted in diagnosis of 79 and 12 rifampicin resistance cases, respectively. Positive predictive value (PPV) for rifampicin resistance detection was high (98%, CI 90.1-99.9), with no statistically significant variation with respect to past history of treatment. Upfront access to Xpert MTB/RIF testing in pediatric presumptive PTB cases was associated with a two-fold increase in bacteriologically-confirmed PTB, and increased detection of rifampicin-resistant TB cases under routine operational conditions across India. These results suggest that routine Xpert MTB/RIF testing is a promising solution to present-day challenges in the diagnosis of PTB in pediatric patients.