From Research to Policy to Programme: Success Story of Seven State Iodine Deficiency Disorders (IDD) Survey in India

Iodine Deficiency Disorders (IDD) constitute the single largest cause of preventable brain damage worldwide. In India the entire population is prone to IDD due to deficiency of iodine in the soil of the subcontinent and consequently the food derived from it. Of these, an estimated 350 million people are at higher risk of IDDs as they consume salt with inadequate iodine. Every year nine million pregnant women and eight million newborns are at risk of IDD in India.On September 13, 2000, the Government of India lifted the ban at the national level on the sale of non-iodized salt (India Gazette 2000). Scientists, civil society, international agencies and other stakeholders joined ranks to fight against this retrograde step by the government of India. The four pronged approach to fight the removal of ban on non- iodized salt comprised of writing advocacy documents, meeting with stakeholders, media campaign and tracking of Universal Salt Iodization (USI) in states by state iodine status surveys.But effective advocacy and media campaign were hampered by lack of scientific data substantiating the magnitude of Iodine Deficiency disorders (IDD) in India. To address this lacuna, state level Iodine status surveys were planned in seven states of India and were executed over next five years in collaboration with various national and international stakeholders.State level IDD surveys were carried out in seven states (Kerala, Tamil Nadu, Orissa, Rajasthan, Bihar, Goa and Jharkhand) from 2000 to 2006 by International Council for Control of Iodine Deficiency Disorders (ICCIDD) in collaboration with state medical colleges, Micronutrient Initiative (MI) and UNICEF. The surveys were carried as per the recommended guidelines of WHO/UNICEF/ICCIDD and used 30 cluster into 40 children sampling methodology. Children in the age group of 6-12 years, women in the household, retail shop keepers and other community stakeholders constituted the study population. All three indicators viz. Total Goiter Rate (TGR), Urinary Iodine (UI) concentration and iodine content of salt (household and retail shop) were studied. TGR ranged from 0.9% in Jharkhand to 14.7% in Goa. The median urinary iodine excretion ranged from 76 µg/L in Goa to 173.2 µg/L in Jharkhand. The household level consumption of adequately iodized salt ( ≥ 15 ppm) ranged from 18.2% in Tamil Nadu to 91.9% in Goa. These state level IDD surveys are the only sub-national (state) level IDD surveys in India where all three indicators viz. iodized salt coverage, urinary iodine and TGR were assessed concurrently.These surveys provided valuable reliable scientific data to back up the need of urgency to re-instate the ban and aided in convincing wider scientific community and policy makers regarding the need for the same. These surveys also aided in capacity building at state level which will provide necessary impetus to sustain USI. The ban on sale of non-iodized salt was finally re-instated in May, 2005.Purpose of the study : To understand the complex policy environment in which National Health Programmes in India are operating.Basic Procedures : A case study approach applying the criteria of policy formulation and policy implementation to National Iodine Deficiency Disorders Control Programme (NIDDCP).Main Findings : The major limiting factor in the implementation of NIDDCP was that the community perceptions about IDD and iodized salt and their interests and beliefs (Values) were not explicitly considered as part of the implementation process. Addressing the values through sustained advocacy, development of partnerships among stakeholders, supply and demand side interventions and more research based on the programme needs helped in achieving sustainability in elimination of IDD.Conclusion : In formulating National Health Programmes in a policy environment, scientific inputs, political will and institutional structure for decision making are necessary but not sufficient. Pro-active recognition values of key stakeholders, continuous and dynamic generation of scientific information and development of partnerships are critical for sustainability of the National Health Programmes

Interactions between the endocrine and immune systems in locusts

The prophenoloxidase cascade in the haemolymph of mature adult Locusta migratoria migratorioides (R & F) is activated in response to injection of laminarin, a -1,3 glucan. Co-injection of adipokinetic hormone-I (Lom-AKH-I) and laminarin prolongs the activation of the enzyme in a dose-dependent manner. However, injections of bacterial lipopolysaccharide (LPS) do not activate prophenoloxidase unless AKH is co-injected, when there is a dose-dependent increase in the level of phenoloxidase that persists in the haemolymph for several hours. Even when AKH is co-injected, the highest levels of phenoloxidase activity are always greater after injection of laminarin than after LPS, and these two immunogens must activate the prophenoloxidase cascade by quite distinct pathways. In the present study, interactions between the endocrine and immune systems were examined with respect to activation of prophenoloxidase and the formation of nodules: injection of LPS induces nodule formation in adult locusts. With LPS from Pseudomonas aeruginosa, nodules form exclusively in dense accumulations in the anterior portion of the abdomen on either side of the dorsal blood vessel associated with the dorsal diaphragm. However, with LPS from Escherichia coli, fewer nodules are formed but with a similar distribution, except that occasionally some nodules are aligned additionally on either side of the ventral nerve cord. Co-injection of Lom-AKH-I with LPS from either bacteria stimulates greater numbers of nodules to be formed. This effect of coinjection of AKH on nodule formation is seen at low doses of hormone with only 0.3 or 0.4 pmol of Lom-AKH-1, respectively, increasing the number of nodules by 50%. Injections of octopamine or 5-hydroxytryptamine do not mimic either of the actions of Lom-AKH-I described here. Co-injection of an angiotensin-converting enzyme inhibitor, captopril, reduces nodule formation in response to injections of LPS but has no effect on the activation of phenoloxidase. Co-injection of an inhibitor of eicosanoid synthesis, dexamethasone, with LPS influences nodule formation (with or without AKH) in different ways according to the dose of dexamethasone used, but does not affect activation of prophenoloxidase. Eicosanoid synthesis is important for nodule formation, but not for the activation of the prophenoloxidase cascade in locust haemolymph

Role of Microbial Enzymes in the Bioremediation of Pollutants: A Review

A large number of enzymes from bacteria, fungi, and plants have been reported to be involved in the biodegradation of toxic organic pollutants. Bioremediation is a cost effective and nature friendly biotechnology that is powered by microbial enzymes. The research activity in this area would contribute towards developing advanced bioprocess technology to reduce the toxicity of the pollutants and also to obtain novel useful substances. The information on the mechanisms of bioremediation-related enzymes such as oxido-reductases and hydrolases have been extensively studied. This review attempts to provide descriptive information on the enzymes from various microorganisms involved in the biodegradation of wide range of pollutants, applications, and suggestions required to overcome the limitations of their efficient use

Drug utilisation study in surgery outpatient department at Ashwini Rural Medical College, Kumbhari, Solapur

Background: Drug utilization studies should be regularly conducted to increase therapeutic efficacy, decrease adverse effects and provide feedback to prescribers to promote the rational use of drugs. Systematic audit of prescriptions in Surgery Outpatient Department are very few in India. This study was conducted to study drug prescription pattern in Surgery Outpatient Department (OPD) in Ashwini Rural Medical College, Kumbhari.Methods: Six hundred prescriptions were screened and analyzed as per the study parameters at Surgery OPD of Ashwini Rural Medical College, Kumbhari. Study parameters like demographic profile of the patient like age, sex and diagnosis were recorded. Also groups of drugs commonly prescribed, number of drugs per patient, drug profile and drawbacks of prescription if any were recorded and analyzed. The percentage of the drugs prescribed by generic names and from the essential drug list was calculated.Results: Most common group of drugs prescribed by physicians were drugs for peptic ulcer (27.26%), followed by antimicrobials (20.89%). The average number of drugs prescribed per patient was 2.98. Drug prescription by generic name was low (8.82%). The incidence of polypharmacy was common occurrence and some prescriptions had small drawbacks like absence of diagnosis, absence of doctor’s signature, absence of patient age etc.Conclusions: Prescribing by generic name and from the essential drug lists should be encouraged. Training sessions on the correct method of writing prescriptions are needed

Drug utilisation study in medicine outpatient department at Ashwini Rural Medical College, Kumbhari, Solapur, India

Background: Drug utilization studies are used to analyze different aspects of the use of drugs and to implement methods of improving therapeutic quality. This study was conducted to study drug prescription pattern in Medicine Outpatient Department (OPD) in Ashwini Rural Medical College, Kumbhari. Methods: Six hundred prescriptions were screened & analyzed as per the study parameters at Medicine OPD of Ashwini Rural Medical College, Kumbhari. Study parameters like demographic profile of the patient like age, sex and diagnosis were recorded. Doctor details and patient details like age, sex and address were analyzed. Also, groups of drugs commonly prescribed, number of drugs per patient, drug profile and drawbacks of prescription if any were recorded and analyzed.Results: Most common group of drugs prescribed by physicians were Analgesics (21.84%), followed by Drugs for Peptic ulcer (17.92%) and Multivitamins/multimineral (14.70%). The average number of drugs prescribed per patient was 2.38. The incidence of Polypharmacy was common occurrence and some prescriptions had small drawbacks like absence of diagnosis, absence of doctor’s signature, etc.Conclusions: Authors conclude that most of the prescriptions which were analyzed at Ashwini Rural Medical College Hospital, Kumbhari, were according to the standard norms of WHO prescriptions and also most of the drugs prescribed were from the list of essential drug list. But still there is scope for improvement in prescription pattern

Survey Paper on Pattern-Enhanced Topic Model for Data Filtering

The machine learning & text mining area topic modeling has been extensively accepted etc. To generate statistical model to classify various topics in a collection of documents topic modelling was proposed. A elementary presumption for those approaches is that the documents in the collection are all about one topic. To represent number of topics in a collection of documents, Latent Dirichlet Allocation (LDA) topic modelling technique was proposed, it is also used in the fields of information retrieval. But its effectiveness in information filtering has not been well evaluated. Patterns are usually thought to be more discriminating than single terms for demonstrating documents. To discovered pattern become crucial when selection of the most representative and discriminating patterns from the huge amount. To overcome limitations and problems, a new information model approach is proposed. Proposed model includes user information important to generate in terms of various topics where each topic is represented by patterns. Patterns are generated from topic models and are organized in terms of their statistical and taxonomic features and the most discriminating and representative patterns are proposed to estimate the document relevant to the user?s information needs in order to filter out irrelevant documents. To access the propose model TREC data collection and Reuters Corpus vol. 1 are used for performanc

The Discovery of Modern Anaesthesia – Contributions of Davy, Clarke, Long, Wells and Morton

While many may argue as to who deserves the most credit for the discovery of modern anaesthesia, events in the late 18 th and early 19 th centuries led to the introduction and development of modern anaesthetic techniques. English physicist and chemist Humphry Davy [1778-1829] first became aware of the sedative and analgesic properties of nitrous oxide in 1795. Although he never experimented with the drug during a surgical procedure, he was the first to suggest that it would be beneficial in relieving pain during surgical procedures. The mind-altering properties of nitrous oxide and ether were often abused for recreational purposes, and the term \u27ether frolics\u27 was coined to describe such use. While physician William Crawford Williamson Long [1815-1878] first used ether during general surgery, medical student William Edward Clarke [1819-1898] was the first to use ether for dental extraction in 1842. Dr. Long neglected to publicize his findings until 1849, thereby denying himself much of the credit he deserved. Dentist Horace Wells [1815-1848] successfully used nitrous oxide for dental procedures, but a public demonstration which he held in January 1845 turned out to be a fiasco. Medical student William Thomas Green Morton [1819-1868] was the first to publicly demonstrate the effectiveness of ether for general surgery on October 16, 1846. This article seeks to give rightful credit to each of these individuals for their unique contributions to the discovery of modern anaesthesia

Experimental Set Up for Vacuum Laboratory

This project deals with study, procurement and installation of some vacuum apparatus for performing experiments in vacuum laboratory. This lab was proposed to be used for graduate and post graduate students. Four experimental set ups were designed as a part of this project. It includes pumping speed measurement of diffusion pump, pumping speed measurement of turbomolecular pump, measurement of conductance of different vacuum elements, and calibration of vacuum gauges. As part of project work, vacuum systems and components were studied, bills of materials were prepared, required components were purchased and installation of experimental set up was done. Pumping speed measurements of high vacuum pumps (diffusion pump and turbomolecular pump) was done by constant volume method. For getting more accuracy Vacuum chamber was tested for leak rate using a MSLD (Mass spectrometer leak detector). Conductance of vacuum elements was measured for different piping arrangements by measuring corresponding changes in effective pumping speed of pumps. Conductance was calculated in low vacuum range using rotary vane pump. Calibration of vacuum gauges was done in low vacuum range by using the method of direct comparison with standard gauge

Awareness about Reproductive Tract Infections among Rural Adolescent Girls in Haryana

Introduction: There are about 350 million adolescents comprising about 22% of the population in the countries of the South- East Asia Region (SEAR). Hygiene related practices of adolescent girls have health impact in terms of increased susceptibility to reproductive tract infections (RTIs) which affects productivity of young adolescents.Objective: The study was conducted to find out the magnitude and awareness of reproductive tract infections among adolescent girls in villages under the Comprehensive Rural Health Services Project (CRHSP), Ballabgarh, Haryana.Methodology: A community based cross sectional study was done among adolescent girls aged 14-19 years. Using simple random sampling technique, 274 girls were interviewed using semi structured interview schedule. Analysis was carried out in Stata version 11.Results: All 274 participants had attained menarche and the mean age at attainment of menarche was 14.2 ±1.4 years. Almost half of the participants (47.1%) were not aware about the causes of RTIs. Seventy one girls (25.9%) reported symptoms of reproductive tract infections. Also, almost half of them did not seek any treatment for RTI.Conclusions: There is a concern that prevalence of untreated reproductive tract infections among adolescent girls is significant especially in rural India. Therefore, proper menstrual hygiene and correct perceptions and beliefs can protect the women from this suffering

Assessment of the level of serum uric acid in patients of pre-eclampsia and their comparison with levels in normotensive pregnancy

Background: Pre-eclampsia is one of the major causes of maternal and perinatal morbidity and mortality. There are various parameters to evaluate pre-eclampsia. S.uric acid levels is one of the important biochemical markers in pre-eclampsia. The objective of current study is to compare the levels of S.uric acid in pre-eclamptic patients and normotensive patients.Methods: A total of 256 antenatal patients, consisting of two groups, 128 patients in each group diagnosed with pre-eclampsia (either earlier or during examination) and 128 control antenatal patients in their third trimester were considered. Both the groups were compared in relation to age, parity, socio economic status and geographical variations. Blood sample (venous blood) of about 5ml was drawn from the ante cubital vein of the patient under all aseptic precautions to estimate S.uric acid levels.Results: The observation of present study shows that the level of serum uric acid is significantly higher in the cases of pre-eclampsia. The value of S.uric acid increases with the severity of pre-eclampsia.Conclusions: It is concluded from this study that high levels of uric acid are found in the serum of pre-eclamptic cases as compared to normotensive cases of the study population. The levels of uric acid are higher in severe cases as compared to the levels in mild and moderate cases