Diagnostic Delay in Pulmonary Tuberculosis: A Cross Sectional study

INTRODUCTION : Early case finding, diagnosis and management are necessary for the control of tuberculosis. Among these, early case finding still remains the key to effective control. One of the components of timely diagnosis is assessing the delay and the factors contributing to it. STUDY RATIONALE : After declaring TB to be a global epidemic in the DOTS strategy was adopted by the WHO in 1993. Over the years, various studies have shown that the case detection rates have remained consistently low. Addressing the delay in diagnosis and treatment is essential in order to improve case detection rates. METHODOLOGY : A cross-sectional study was conducted among newly diagnosed PTB patients on intensive phase of Category I ATT in Zone VIII of Chennai Corporation. Delay was analyzed at 1) Patient level 2)Health care level 3) Total delay from onset of symptoms till treatment initiation RESULTS : Almost two-thirds of the study participants sought health care providers for their symptoms. Others measures undertaken included pharmacies, self-medication, traditional medicine etc. The median duration of patient delay was 35 days (IQR 25-50), health system delay was 4 days (IQR 3-6 days), diagnosis delay 36 days (IQR 25 – 51 days), treatment delay 3 days (IQR 3-5 days) and total delay of 39 days (IQR 29-55 days). DISCUSSION : There was an unacceptable delay in the part of the patients in seeking health care. Age ≥35 years, smoking, seeking health care from places other than health care providers were significantly associated with longer delays. CONCLUSION : Patient delay contributes to 90% of the total delay in the diagnosis and treatment of pulmonary tuberculosis patients. Addressing the associated factors is needed for reducing delays. RECOMMENDATIONS : People who smoke may be included to be at increased suspicion for TB when they experience chest symptoms. Stringent monitoring to reduce over the counter supply of drugs may also be undertaken to facilitate early health care seeking

PHOTOSENSITIVE EFFECT OF THE BIOCHEMICAL AND ECONOMIC TRAITS OF Bombyx mori L.

The silkworm is by nature very delicate and sensitive to environmental conditions. The ecological factors, chiefly temperature, humidity and light during rearing show significant effect on growth larvae and finally cocoon crop quality. Silkworms are photosensitive and they have a tendency to crawl towards dim light. They do not like either strong light or complete darkness. In this way, based on various exposures of light on the effect of biochemical content and economic traits of silkworm were recorded. Biochemical content such as protein is highly essential for insects. The intracellular transport of the silk protein is dependent on hydrophobicity or hydrophilicity of the amino acid residues of the heavy and light chain of the silk protein and the haemolymph is the only extracellular fluid of insects with diverse functions and serves as reservoir for the products required for every physiological activity of the insect body, thus changes in the composition of haemolymph reflect the physiological and biochemical transformations taking place in the insect tissue. In this way of study, effect of light on biochemical content such as protein and carbohydrate of haemolyph and silk gland are significantly increased. The protein content was high in the haemolymph (17.48%) when the larvae exposed to 5 watt light and silk gland (66.67%) in 3 watt exposure group but fat body (44.33 %) when the larvae exposed to 8 watt. The carbohydrate content of haemolymph (35.54 %), silk gland (12.85%) and fat body (57.26 %) were significantly increased in 3 watt exposure group. In this findings, biochemical content had direct relation to economic traits of B. mori. The cocoon characters such as cocoon weight (28.42 per cent), pupal weight (20.9 per cent), shell weight (71 per cent) and shell ratio (33.48 per cent) were significantly increased in the 3 watt exposed group