Evaluation of functioning of ICDS project areas under Indore and Ujjain divisions of the state of Madhya Pradesh

Background: Integrated Child Development Services (ICDS) is recognized worldwide as one of the most efficient community based programmes promoting early childhood care. Regular evaluations of the programme have been conducted to make it more effective and adequate for the beneficiaries. Objectives: To evaluate the functioning of the Anganwadi Centers under different project areas of Indore and Ujjain Divisions. Methods: Under the present evaluation system one ICDS project and five Anganwadi Centers under the project area (AWCs) were visited on a monthly basis and services provided reviewed. Findings reported are from nine project areas under Indore and Ujjain Divisions in the state of Madhya Pradesh from October 2008 – June 2009. Results: A total of 45 centers were evaluated. 29 centers were operating from rented buildings and storage facilities were lacking at 19 of the centers. Though the quality of food was acceptable to the beneficiaries shortage of food was a problem at the centers. Absence of Pre-School Education (PSE) and Nutrition and Health Education (NHED) Kits compromised PSE and NHED activities at the centers. Unavailability of medicine kits, lack of regular visits by the ANMs to the centers and absence of routine health check up of beneficiaries were other problems encountered under the project areas surveyed. Availability of a doctor under each project area was stated as a major need by the workers. Conclusion: Coordinated steps catering to different services provided at the centers are needed to optimize the functioning of the ICDS scheme

Impact of Educational Intervention Measures on Knowledge regarding HIV/ Occupational Exposure and Post Exposure Prophylaxis among Final Year Nursing Students of a Tertiary Care Hospital in Central India

Amongst the different Health Care Personnel nurses are at a greater risk of being accidentally exposed to HIV and other Blood Borne Pathogens. The present study was conducted among 50 final year nursing students of a Medical College Hospital to assess the knowledge regarding HIV, occupational exposure and Post Exposure Prophylaxis (PEP) among the students and analyses the impact of educational intervention measures on the issues amongst the study subjects. A Pre-designed and Pre-tested semi-structured questionnaire was used to evaluate the level of knowledge before and after educational intervention sessions. Knowledge regarding risk of transmission of HIV by needle-stick injury and body fluids against which universal precautions were mandatory increased by 72% following the intervention sessions (χ2 = 53.202, p <0.001). 72% and 36% respondents correctly knew the duration within which to start PEP and the drugs available for PEP, post educational sessions 98% and 96% students were aware of it: the difference being statistically significant (χ2 = 11.294, p <0.001) and (χ2 = 37.748, p <0.001) respectively. The mean pre-intervention score was 8.32; mean post-intervention score was 14.40: statistical analysis showed the results to be significant (t= 13.857, p< 0.001). The study reflects that there is a dearth of knowledge among the study group. Incorporating the concerned issues in the academic curriculum to provide the students with adequate knowledge and information during their formative years is needed

Pathological Staging of Renal Cell Carcinoma: A Review of 300 Consecutive Cases

Aims: Pathological staging of renal cell carcinoma (RCC) can be challenging compared to other cancer types, as invasion often manifests as finger‐like protrusions into vascular spaces or renal sinus tissue. Although prior studies have shown larger tumour size to be correlated highly with renal sinus invasion, prospective data on evaluating pathological stage are limited. We evaluated a large series reported by one urological pathologist. Methods and results: Three hundred consecutive specimens were reviewed. Tumours larger than 5 cm were routinely sampled extensively or grossly re‐reviewed when no extrarenal extension was identified on initial examination. Apparent multifocal disease was assessed critically for intravascular spread. Retrograde venous invasion was reported in 15 of 300 (5%) cases, 13 of 15 of which were clear cell RCC. Of a total of 163 specimens with clear cell histology, only five of 34 (15%) tumours 7 cm or larger were reported as pT2, all of which had an explanatory comment indicating the absence of definitive extrarenal spread. In contrast, 15 of 20 (75%) pT2 tumours were non‐clear cell histology (papillary, chromophobe and translocation‐associated). Comparing pT3a or higher tumours, the median tumour size in cases with retrograde venous invasion was 8.0 cm, compared to 6.2 cm in cases without retrograde venous invasion (P = 0.005). ConclusionsOur findings support that retrograde venous invasion should be considered carefully before diagnosing multifocal clear cell RCC, which is rare in the sporadic setting. In the absence of vascular invasion, multifocal clear cell papillary RCC can be a mimic. pT2 occurs more frequently with non‐clear cell histology (particularly papillary or chromophobe RCC).https://scholarlycommons.henryford.com/merf2019basicsci/1002/thumbnail.jp