An Assessment of Knowledge and Practices Regarding Tuberculosis in the Context of RNTCP Among Non Allopathic Practitioners in Gwalior District

Introduction: India has the highest TB burden accounting for one-fifth of the global incidence with an estimated 1.98 million cases. Non- allopathic practitioners are the major service providers especially in rural and peri-urban areas, treating not just patients of diarrhea, respiratory infections and abdominal Pain but also of tuberculosis. Objectives: To assess the knowledge of sign and symptoms of TB and its management as per the RNTCP guidelines and to assess the practicing pattern regarding tuberculosis. Material & Methods: The present was carried out among the registered non allopathic practitioners providing their services in Gwalior District during the study period. A total of 150 non allopathic practitioners of various methods from both government and private sectors were interviewed using a pre-designed, pre-tested semi-structured questionnaire. The information was collected on the General profile of the participant, knowledge about signs and symptoms of TB and its management, practices commonly adopted in the management and their views on involvement of non allopathic practitioners in RNTCP programme. Result: The average score of government practitioners was 7.3 compared to 4.6 by private practitioners. There was a statistically significant difference between the two group on issue related to the management of TB patients as per the RNTCP guidelines. Government practitioners relied mostly on sputum examination for diagnosis and follow up compared to private practitioners who chose other modalities like X-ray, blood examination for this work. Conclusion: There is a gap in knowledge and practices of practitioners of both the sectors. Some serious efforts were required to upgrade the knowledge of non allopathic practitioners if the government is serious about controlling tuberculosis in India

Thermodynamics and Lemaitre-Tolman-Bondi void models

It has been argued in the literature that in order to make a matter dominated Friedmann-Lemaitre-Robertson-Walker universe compatible with the generalized second law of thermodynamics, one must invoke dark energy, or modified gravity. In the present article we investigate if in a similar spirit, inhomogeneous cosmological models can be motivated on thermodynamic grounds. We examine a particular minimal void Lemaitre-Tolman-Bondi inhomogeneous model which agrees well with observations. While on the one hand we find that the entropy associated with the apparent horizon is not well-behaved thermodynamically, on the other hand the canonical Weyl curvature entropy shows satisfactory thermodynamic behavior. We suggest that evolution of canonical Weyl curvature entropy might be a useful way to evaluate the thermodynamic viability of inhomogeneous cosmologies.Comment: This version: one paragraph added at the end, acknowledgements and references added, matches published versio

Fourth Order Gravity, Scalar-Tensor-Vector Gravity, and Galaxy Rotation Curves

The Lambda-CDM model is the best fit to cosmological data, and to the observed galactic rotation curves. However, in the absence of a direct detection of dark matter one should explore theories such as MOND, and perhaps also modified gravity theories like fourth order gravity and Scalar-Tensor-Vector Gravity [STVG] as possible explanations for the non-Keplerian behaviour of galaxy rotation curves. STVG has a modified law for gravitational acceleration which attempts to fit data by fixing two free parameters. We show that, remarkably, the biharmonic equation which we get in the weak field limit of the field equations in a fourth order gravity theory implies a modification of Newtonian acceleration which is precisely of the same repulsive Yukawa form as in the STVG theory, and the corrections could in principle be large enough to try and explain the observed rotation curves. We also explain how our model provides a first principles understanding of MOND. We also show that STVG and fourth order gravity predict an acceleration parameter $a_0$ whose value is of the same order as in MOND.Comment: 13 pages, 3 figures, major revision including change in title and conclusions, accepted for publication in Phys. Rev.