Collaborative Learning for Ecosystem Services in the Context of Poverty Alleviation: A Case from India

Unplanned and unregulated urbanisation and industrialisation has led to large-scale degradation of the environment, including that of water bodies in India (Mukherjee, 2009). Communities and governments have, over time, tried innovative approaches to the development and management of water bodies. Often, these approaches are focused on physical restoration, ignoring the human component – especially the dependence of people on the water body for their livelihood and sustenance. The ecosystem services for poverty alleviation (ESPA) approach seeks to tie together the various social and environmental requirements in a holistic manner and, in the process, recognise the interdependence between humans and nature. The Supporting Urban Sustainability (SUS) Programme focuses on an ESPA approach in urban settings using the methods of collaborative learning. The purpose of this article is to illustrate how an emerging theory, ESPA, can be institutionalised through a collaborative-learning process. The research is qualitative in nature. It explains the local Ahmedabad case study in order to provide insight into the SUS Programme activities, and then takes a broader view of collaborative learning across the other participating cities in the SUS Programme. The data for the case study on Ahmedabad city was collected during the implementation of the SUS Programme at the site, while the data on collaborative learning was collected from city team members engaged in the SUS Programme across a number of SUS Programme sites through a survey questionnaire. The latter data was then analysed by grouping narratives with reference to various aspects of collaborative learning from the participants’ points of view. The outcomes could thereafter be used to support the development of collaborative learning projects elsewhere, and would also be useful for further developing the work done during the Ahmedabad case study

TRIVIDHA KARMA IN SURGICAL PARLANCE- A CONCEPTUAL STUDY

In Ayurvedic classics there are various types of treatment and Shastra chikitsa is one among them. Purva Karma Pradhana Karma, Paschat Karma are Trividha Karma. According to Acharya Sushruta, Purva Karma means preparation of patient along with collecting all the materials needed during the Pradhana karma. Ashtaviddha Shastra Karma is included in Pradhana Karma. Paschat Karma includes post operative care. Sushruta division of surgical activity into three parts i.e., pre- operative, operative and post-operative based on sound scientific principles. Sushruta has also described the pre-operative appreciation of foreign body, its size, shape, and exact location within the body and appropriate instrument for its removal should be selected pre-operatively. He has also mentioned the pre-operative diet and starvation for various types of surgeries. He has also emphasized that asepsis and antisepsis precaution should be taken, wound should be protected from dangerous and invisible creatures (Nishachara). Fumigation of Vranitaagara should be done for ten days, twice a day. By virtue of this article, we can understand the systematic method of arranging the surgical experience of arranging the surgical experience of the older surgeon, about preliminary measures, principal measures and after measures. All the procedures included under these three headings i.e., Trividdha karma plays an important role in successful and complication free surgery

The usefulness of a new rapid diagnostic test, the First Response® Malaria Combo (pLDH/HRP2) card test, for malaria diagnosis in the forested belt of central India

<p>Abstract</p> <p>Background</p> <p>Malaria presents a diagnostic challenge in tribal belt of central India where two Plasmodium species, <it>Plasmodium falciparum </it>and <it>Plasmodium vivax</it>, are prevalent. In these areas, rapid detection of the malaria parasites and early treatment of infection remain the most important goals of disease management. Therefore, the usefulness of a new rapid diagnostic (RDT), the First Response^®Combo Malaria Ag (pLDH/HRP2) card test was assessed for differential diagnosis between <it>P. falciparum </it>with other Plasmodium species in remote villages of Jabalpur district.</p> <p>Methods</p> <p>A finger prick blood sample was collected to prepare blood smear and for testing with the RDT after taking informed consent. The figures for sensitivity, specificity, accuracy and predictive values were calculated using microscopy as gold standard.</p> <p>Results</p> <p>Analysis revealed that overall, the RDT was 93% sensitive, 85% specific with a positive predictive value (PPV) of 79%, and a negative predictive value (NPV) of 95%. The accuracy 88% and J-index was 0.74. For <it>P. falciparum</it>, the sensitivity and specificity of the test were 96% and 95% respectively, with a PPV of 85% and a NPV of 99%. The RDT accuracy 95% and J-index was 0.84. For non-falciparum malaria, the sensitivity, specificity and accuracy were 83%, 94% and 92% respectively with a PPV of 69% and a NPV of 97%.</p> <p>Conclusion</p> <p>The RDTs are easy to use, reliable and simple to interpret. RDTs are more suited to health workers in situations where health services are deficient or absent. Therefore, the test can be used as an epidemiological tool for the rapid screening of malaria.</p

Field and laboratory comparative evaluation of rapid malaria diagnostic tests versus traditional and molecular techniques in India

<p>Abstract</p> <p>Background</p> <p>Malaria presents a diagnostic challenge in most tropical countries. Microscopy remains the gold standard for diagnosing malaria infections in clinical practice and research. However, microscopy is labour intensive, requires significant skills and time, which causes therapeutic delays. The objective of obtaining result quickly from the examination of blood samples from patients with suspected malaria is now made possible with the introduction of rapid malaria diagnostic tests (RDTs). Several RDTs are available, which are fast, reliable and simple to use and can detect <it>Plasmodium falciparum </it>and non-falciparum infections or both. A study was conducted in tribal areas of central India to measure the overall performance of several RDTs for diagnosis of <it>P. falciparum </it>and non-falciparum infections in comparison with traditional and molecular techniques. Such data will be used to guide procurement decisions of policy makers and programme managers.</p> <p>Methods</p> <p>Five commercially available RDTs were tested simultaneously in field in parallel with peripheral blood smears in outbreak-affected areas. The evaluation is designed to provide comparative data on the performance of each RDT. In addition, molecular method i.e. polymerase chain reaction (PCR) was also carried out to compare all three methods.</p> <p>Results</p> <p>A total of 372 patients with a clinical suspicion of malaria from Bajag Primary Health Centre (PHC) of district Dindori and Satanwada PHC of district Shivpuri attending the field clinics of Regional Medical Research Centre were included in the study. The analysis revealed that the First Response Malaria Antigen pLDH/HRP2 combo test was 94.7% sensitive (95% CI 89.5-97.7) and 69.9% specific (95% CI 63.6-75.6) for <it>P. falciparum</it>. However, for non-falciparum infections (<it>Plasmodium vivax</it>) the test was 84.2% sensitive (95% CI 72.1-92.5) and 96.5% specific (95% CI 93.8-98.2). The Parascreen represented a good alternative. All other RDTs were relatively less sensitive for both <it>P. falciparum </it>and non-falciparum infections.</p> <p>Conclusions</p> <p>The results in this study show comparative performance between microscopy, various RDTs and PCR. Despite some inherent limitation in the five RDTs tested, First Response clearly has an advantage over other RDTs. The results suggest that RDTs could play and will play an important role in malaria diagnosis.</p

Diagnostic and prognostic utility of an inexpensive rapid on site malaria diagnostic test (ParaHIT f) among ethnic tribal population in areas of high, low and no transmission in central India

BACKGROUND: Malaria presents a diagnostic challenge in most tropical countries. Rapid detection of the malaria parasite and early treatment of infection still remain the most important goals of disease management. Therefore, performance characteristics of the new indigenous ParaHIT f test (Span diagnostic Ltd, Surat, India) was determined among ethnic tribal population in four districts of different transmission potential in central India to assess whether this rapid diagnostic test (RDT) could be widely applied as a diagnostic tool to control malaria. Beyond diagnosis, the logical utilization of RDTs is to monitor treatment outcome. METHODS: A finger prick blood sample was collected from each clinically suspected case of malaria to prepare blood smear and for testing with the RDT after taking informed consent. The blood smears were read by an experienced technician blinded to the RDT results and clinical status of the subjects. The figures for specificity, sensitivity, accuracy and predictive values were calculated using microscopy as gold standard. RESULTS: The prevalence of malaria infection estimated by RDT in parallel with microscopy provide evidence of the type of high, low or no transmission in the study area. Analysis revealed (pooled data of all four epidemiological settings) that overall sensitivity, specificity and accuracy of the RDT were >90% in areas of different endemicity. While, RDT is useful to confirm the diagnosis of new symptomatic cases of suspected P. falciparum infection, the persistence of parasite antigen leading to false positives even after clearance of asexual parasitaemia has limited its utility as a prognostic tool. CONCLUSION: The study showed that the ParaHIT f test was easy to use, reliable and cheap. Thus this RDT is an appropriate test for the use in the field by paramedical staff when laboratory facilities are not available and thus likely to contribute greatly to an effective control of malaria in resource poor countries

Therapeutic efficacy of artemether–lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria from three highly malarious states in India

Additional file 1. Flowchart showing site-wise enrolment and follow-up profile

Burden of malaria in pregnancy in Jharkhand State, India

<p>Abstract</p> <p>Background</p> <p>Past studies in India included only symptomatic pregnant women and thus may have overestimated the proportion of women with malaria. Given the large population at risk, a cross sectional study was conducted in order to better define the burden of malaria in pregnancy in Jharkhand, a malaria-endemic state in central-east India.</p> <p>Methods</p> <p>Cross-sectional surveys at antenatal clinics and delivery units were performed over a 12-month period at two district hospitals in urban and semi-urban areas, and a rural mission hospital. Malaria was diagnosed by Giemsa-stained blood smear and/or rapid diagnostic test using peripheral or placental blood.</p> <p>Results</p> <p>2,386 pregnant women were enrolled at the antenatal clinics and 718 at the delivery units. 1.8% (43/2382) of the antenatal clinic cohort had a positive diagnostic test for malaria (53.5% <it>Plasmodium falciparum</it>, 37.2% <it>Plasmodium vivax</it>, and 9.3% mixed infections). Peripheral parasitaemia was more common in pregnant women attending antenatal clinics in rural sites (adjusted relative risk [aRR] 4.31, 95%CI 1.84-10.11) and in those who were younger than 20 years (aRR 2.68, 95%CI 1.03-6.98). Among delivery unit participants, 1.7% (12/717) had peripheral parasitaemia and 2.4% (17/712) had placental parasitaemia. Women attending delivery units were more likely to be parasitaemic if they were in their first or second pregnancy (aRR 3.17, 95%CI 1.32-7.61), had fever in the last week (aRR 5.34, 95%CI 2.89-9.90), or had rural residence (aRR 3.10, 95%CI 1.66-5.79). Malaria control measures including indoor residual spraying (IRS) and untreated bed nets were common, whereas insecticide-treated bed nets (ITN) and malaria chemoprophylaxis were rarely used.</p> <p>Conclusion</p> <p>The prevalence of malaria among pregnant women was relatively low. However, given the large at-risk population in this malaria-endemic region of India, there is a need to enhance ITN availability and use for prevention of malaria in pregnancy, and to improve case management of symptomatic pregnant women.</p

IMPORTANCE OF UPYANTRA IN SHALYA CHIKITSA

Ayurveda is considered as one of the best health science of ancient era. There are 8 branches of Ayureveda and Shalya chikitisa is the most important branch of Ayurveda due to its quick action (Ashukrye –Karnat). Shalya Chikitisa includes different surgical and para surgical technique which can be moulded depending upon the Immunity of Patients. Today in modern scenario, where advance Science &amp; technology is going to its highest peak &amp; medical Science is becoming emphasis on knowledge of Upyantra seems quite obsolete. Sometime the situation arise when we don’t have proper medical facility during natural calamities where giving medical faculty to every person in not possible. To combat such disastrous situation the knowledge of accessory medical equipment is very important so, that we can survive. Acharya Sushrut is considered “Father of Surgery” who know how to overcome such situation with his unique power of thinking when situation is opposite for survival. Acharya Dalhan, Acharaya Vagbatta, Achary Sushrut had explained different Yantra and Upyantra which can be used according to the patients immunity. In modern surgery there is no treatment option. They make patient to fit the available treatment but in ancient health science i.e., in Ayurved there are different way of treating patients depending upon their nature of body. Various types of Yantras used in Shalya Chikitsa includes Swastik Yantra, Taal Yantra samdansha Yantra, Shalaka Yantra, Naadia Yantra and Upayantra. These instruments place an at most role in the success of Shalya Chikitisa and without them the practical work of concept of Shalya Chikitisa cannot be made