Barriers and facilitators to informal healthcare provider engagement in the national tuberculosis elimination program of India: An exploratory study from West Bengal

India has a high burden of Tuberculosis (TB), accounting for a significant portion of global cases. While efforts are being made to engage the formal private sector in the National TB Elimination Program (NTEP) of India, there remains a significant gap in addressing the engagement of Informal Healthcare Providers (IPs), who serve as the first point of contact for healthcare in many communities. Recognizing the increasing evidence of IPs' importance in TB care, it is crucial to enhance their engagement in the NTEP. Therefore, this study explored various factors influencing the engagement of IPs in the program. A qualitative study was conducted in West Bengal, India, involving 23 IPs and 11 Formal Providers (FPs) from different levels of the formal health system. Thematic analysis of the data was conducted following a six-step approach outlined by Braun and Clarke. Three overarching themes were identified in the analysis, encompassing barriers and facilitators to IPs' engagement in the NTEP. The first theme focused on IPs' position and capacity as care providers, highlighting their role as primary care providers and the trust and acceptance extended by the community. The second theme explored policy and system-level drivers and prohibitors, revealing barriers such as role ambiguity, competing tasks, and quality of care issues. Facilitators such as growing recognition of IPs' importance in the health system, an inclusive incentive system, and willingness to collaborate were also identified. The third theme focused on the relationship between the formal and informal systems, highlighting a need to strengthen the relationship between the two. This study sheds light on factors influencing the engagement of IPs in the NTEP of India. It emphasizes the need for role clarity, knowledge enhancement, and improved relationships between formal and informal systems. By addressing these factors, policymakers and stakeholders can strengthen the engagement of IPs in the NTEP

Amelioration of ionizing radiation induced lipid peroxidation in mouse liver by<i style=""> Moringa oleifera</i> Lam. leaf extract

209-215Protective effect of Moringa oleifera leaf extract (MoLE) against radiation-induced lipid peroxidation has been investigated. Swiss albino mice, selected from an inbred colony, were administered with MoLE (300 mg/kg body wt) for 15 days before exposing to a single dose of 5 Gy 60Co-gamma radiation. After treatments, animals were necropsied at different post irradiation intervals (days 1, 7 and 15) and hepatic lipid peroxidation and reduced glutathione (GSH) contents were estimated to observe the relative changes due to irradiation and its possible amelioration by MoLE. It was observed that, MoLE treatment restored GSH in liver and prevented radiation induced augmentation in hepatic lipid peroxidation. Phytochemical analysis showed that MoLE possess various phytochemicals such as ascorbic acid, phenolics (catechin, epicatechin, ferulic acid, ellagic acid, myricetin) etc., which may play the key role in prevention of hepatic lipid peroxidation by scavenging radiation induced free radicals

Seabuckthron<i style="mso-bidi-font-style:normal"> </i>(<i style="mso-bidi-font-style:normal">Hippophae rhamnoides </i>L.) leaf extract ameliorates the gamma radiation mediated DNA damage and hepatic alterations

952-964In vitro assessment showed that H. rhamnoides<span style="mso-fareast-font-family: AdvGulliv-R;mso-bidi-language:BN" lang="EN-GB"> (HrLE) extract possessed free radical scavenging activities and can protect gamma (γ) radiation induced supercoiled DNA damage. For in vivo study, Swiss albino mice were administered with HrLE (30 mg/kg body weight) for 15 consecutive days before exposing them to a single dose of 5 Gy of γ radiation. HrLE significantly prevented the radiation induced genomic DNA damage indicated as a significant reduction in the comet parameters. The lipid peroxidation, liver function enzymes, expression of phosphorylated NFκB (p65) and IκBα increased whereas the endogenous antioxidants diminished upon radiation exposure compared to control. Pretreatment of HrLE extract ameliorated these changes. Based on the present results it can be concluded that H. rhamnoides<span style="mso-fareast-font-family: AdvGulliv-R;mso-bidi-language:BN" lang="EN-GB"> possess a potential preventive element in planned and accidental nuclear exposures. </span

Survival probability as a function of time after exposure of Swiss albino mice to IR alone (10 Gy) or IR (10 Gy) + FA at different doses.

<p>Survival probability as a function of time after exposure of Swiss albino mice to IR alone (10 Gy) or IR (10 Gy) + FA at different doses.</p

FA effect on radiation induced alteration of reduced glutathione (nmol/mg protein) level in mice.

<p>Bar 1: control group(C), Bar 2: mice treated with FA (50 mg/kg body weight) for 5 days (FA), Bar 3, 4, and 5: mice treated with 10 Gy γ-radiation and were eventually sacrificed after 6, 24 and 48 hours of radiation exposure (IR6, IR24 & IR48). Bar 6, 7 and 8: mice treated with FA plus irradiated (FA+IR6, FA+IR24 & FA+IR48). Error bars were SEM for n = 8. <i>p</i><0.05 was considered significant. Statistical comparison: * control vs. IR, #IR vs. FA+IR.</p

Determination of FA availability in plasma at different time points by HPLC.

<p>HPLC chromatograms of free FA in mice plasma were recorded at 320(A) after 5 minutes of FA administration; (B) after 15 minutes of FA administration; (C) after 30 minutes of FA administration; (D) after 6 hour of FA administration; (E) after 24 hours of FA administration; (F) after 48 hours of FA administration.</p