No longer diseases of the wealthy : prevalence and health-seeking for self-reported chronic conditions among urban poor in Southern India

Background: The burden of chronic conditions is high in low-and middle-income countries and poses a significant challenge to already weak healthcare delivery systems in these countries. Studies investigating chronic conditions among the urban poor remain few and focused on specific chronic conditions rather than providing overall profile of chronic conditions in a given community, which is critical for planning and managing services within local health systems. We aimed to assess the prevalence and health-seeking behaviour for self-reported chronic conditions in a poor neighbourhood of a metropolitan city in India. Methods: We conducted a house-to-house survey covering 9299 households (44514 individuals) using a structured questionnaire. We relied on self-report by respondents to assess presence of any chronic conditions, including diabetes and hypertension. Multivariable logistic regression was used to analyse the prevalence and health-seeking behaviour for self-reported chronic conditions in general as well as for diabetes and hypertension in particular. The predictor variables included age, sex, income, religion, household poverty status, presence of comorbid chronic conditions, and tiers in the local health care system. Results: Overall, the prevalence of self-reported chronic conditions was 13.8% (95% CI = 13.4, 14.2) among adults, with hypertension (10%) and diabetes (6.4%) being the most commonly reported conditions. Older people and women were more likely to report chronic conditions. We found reversal of socioeconomic gradient with people living below the poverty line at significantly greater odds of reporting chronic conditions than people living above the poverty line (OR = 3, 95% CI = 1.5, 5.8). Private healthcare providers managed over 80% of patients. A majority of patients were managed at the clinic/health centre level (42.9%), followed by the referral hospital (38.9%) and the super-specialty hospital (18.2%) level. An increase in income was positively associated with the use of private facilities. However, elderly people, people below the poverty line, and those seeking care from hospitals were more likely to use government services. Conclusions: Our findings provide further evidence of the urgent need to improve care for chronic conditions for urban poor, with a preferential focus on improving service delivery in government health facilities

The contribution of the eighteenth century poetry to the religious thought and attitude of contemporary England

This item was digitized by the Internet Archive. Thesis (M.A.)--Boston Universityhttps://archive.org/details/contributionofei00dev

Coping with tuberculosis and directly observed treatment : a qualitative study among patients from South India

Background: In India, the Revised National TB control programme (RNTCP) offers free diagnosis and treatment for tuberculosis (TB), based on the Directly Observed Treatment Short course (DOTS) strategy. We conducted a qualitative study to explore the experience and consequences of having TB on patients enrolled in DOTS and their caretakers in Tumkur district, located in a southern state of India, Karnataka. Methods: We conducted 33 in-depth interviews on a purposive sample of TB patients from three groups: (1) patients who reached RNTCP directly on their own and took DOTS at RNTCP; (2) patients who were referred by private practitioners (PPs) to RNTCP and took DOTS at RNTCP; and (3) patients diagnosed by RNTCP and took DOTS from PPs. Data was analyzed using a thematic approach with the support of NVivo9. Results: The study revealed that TB and DOTS have a large impact on patient's lives, which is often extended to the family and caretakers. The most vulnerable patients faced the most difficulty in accessing and completing DOTS. The family was the main source of support during patient's recovery. Patients residing in rural areas and, taking DOTS from the government facilities had to overcome many barriers to adhere to the DOTS therapy, such as long travelling distance to DOTS centers, inconvenient timings and unfavorable attitude of the RNTCP staff, when compared to patients who took DOTS from PPs. Advantages of taking DOTS from PPs cited by the patients were privacy, flexibility in timings, proximity and more immediate access to care. Patients and their family had to cope with stigmatization and fear and financial hardships that surfaced from TB and DOTS. Young patients living in urban areas were more worried about stigmatisation, than elderly patients living in rural areas. Patients who were referred by PPs experienced more financial problems compared to those who reached RNTCP services directly. Conclusion: Our study provided useful information about patient's needs and expectations while taking DOTS. The development of mechanisms within RNTCP towards patient centered care is needed to enable patients and caretakers cope with disease condition and adhere to DOTS

Further studies on changes in protein fractions of fish muscle during storage in ice

The changes in the major protein nitrogen fractions of two commercially important fishes of Indian waters, viz., mackerel (Rastrelliger kanagurta) and lactarius (Lactarius lactarius), during storage in ice are reported. The significance of the findings is discussed in comparison with the results of a similar study on two species of marine prawns and oil sardine, reported earlier

Frozen storage characteristics of ribbon fish

The frozen storage characteristics of ribbon fish, Trichiurus sp., in different forms are reported

Effect of cooking and drying on carbonyls of oil sardine

Changes in the total as well as major individual carbonyls of oil sardine during steam cooking, oven drying, sun drying and freeze drying are presented. Carbonyls extracted with hexane were converted to their 2:4 dinitro phenyl hydrazone (DNPH) derivatives and were separated into major classes by column chromatography on celite/magnesia. Individual carbonyls were then identified by capillary gas chromatography of the DNPH derivatives. Dehydration and heating increase the carbonyl production from highly unsaturated fish lipids. The carbonyls produced react with other muscle constituents leading to complex changes. The influence of the mode of dehydration on these different aspects and their net effect on flavour are discussed

Effect of preprocessing storage conditions on the carbonyls of oil sardine

Changes in the total as well as major individual carbonyls of oil sardine muscle during storage at room temperature for 24 h and in crushed ice up to 6 days are reported. Carbonyls extracted with hexane were converted to their 2:4 dinitrophenyl hydrazone (DNPH) derivatives and were separated into major classes by column chromatography on celite/magnesia. Individual carbonyls were then identified by capillary gas chromatography of these derivatives. Though absolute values for carbonyls exhibited wide variations depending upon the degree of freshness, the pattern of changes in the carbonyls during storage of fish under different conditions gave an insight into the influence of carbonyls on flavour. The significance of the findings is discussed

Observations on changes in the major protein nitrogen fraction of prawns and sardines during ice storage

Changes in the major protein nitrogen fractions (sarcoplasmic, myofibrillar, stroma) have been studied in two species of prawns and in oil sardine held in ice storage. Myofibrillar proteins were observed to get denatured at a rapid rate as determined by salt extractability method. The sarcoplasmic proteins were not denatured to any considerable extent. With sardine however, the extraction of myofibrillar proteins was inhibited rather in the uniced condition itself presumably owing to the presence of free fatty acids

Docking-based virtual screening of known drugs against murE of Mycobacterium tuberculosis towards repurposing for TB.

Repurposing has gained momentum globally and become an alternative avenue for drug discovery because of its better success rate, and reduced cost, time and issues related to safety than the conventional drug discovery process. Several drugs have already been successfully repurposed for other clinical conditions including drug resistant tuberculosis (DR-TB). Though TB can be cured completely with the use of currently available anti-tubercular drugs, emergence of drug resistant strains of Mycobacterium tuberculosis and the huge death toll globally, together necessitate urgently newer and effective drugs for TB. Therefore, we performed virtual screening of 1554 FDA approved drugs against murE, which is essential for peptidoglycan biosynthesis of M. tuberculosis. We used Glide and AutoDock Vina for virtual screening and applied rigid docking algorithm followed by induced fit docking algorithm in order to enhance the quality of the docking prediction and to prioritize drugs for repurposing. We found 17 drugs binding strongly with murE and three of them, namely, lymecycline, acarbose and desmopressin were consistently present within top 10 ranks by both Glide and AutoDock Vina in the induced fit docking algorithm, which strongly indicates that these three drugs are potential candidates for further studies towards repurposing for TB