Economic burden of hypertension care on households of Malwani slum of Mumbai: a cross-sectional study

Background: Hypertension is a chronic non-communicable disease that effects adversely on heart, brain and kidney. Nearly 2/3rd of all hypertensive patients live in low and middle income countries, so the economic burden of hypertension is huge. India is one of those countries which spent more than 1/3rd of all income on CVD and hypertension. This study was conceptualized to study the disease and economic burden of hypertension.Methods: A cross-sectional study was conducted in New Collector Compound (NCC) of Malwani. Five plots of NCC were selected by simple random sampling. A list of hypertensive patients was prepared by house-to-house survey. Fifty per cent patients were selected randomly for studying economic burden.Results: The study covered 447 households and 2360 persons. Eighty participants (3.4%) were found hypertensive. The average annual total cost of hypertension and related disorders was Rs. 7154. It was Rs. 6073 and Rs. 8235 for government and private respectively. Only 7.50% households were not incurring any cost of illness. The average annual out of pocket expenditure (OOPE) was Rs. 4042 and Rs. 7621 for government and private facilities respectively. Fifteen per cent households were incurring catastrophic expenditure at highest threshold of 40%. The catastrophic spending led to impoverishment of 34.2% households.Conclusions: High prevalence of hypertension, high OOPE, high incidence of catastrophic spending and impoverishment among households intensively reflect the need of interventions. Early preventive measures may be a key in controlling economic and disease burden. There is need to provide the financial risk protection against the OOPE for outpatient care.

Clinical study of ventilator-associated pneumonia in tertiary care hospital, Kolhapur, Maharashtra, India

Background: Ventilator‑associated pneumonia (VAP) is the most common nosocomial infection acquired by patients admitted in the intensive care unit (ICU). However, there is very less information or clinical data available on the occurrence of VAP in Kolhapur, Maharashtra.Methods: study aims to determine the Incidence of VAP in ICU, to study the association between causative microorganism and sensitivity, and to study the association between prognosis and incidence of VAP. Settings and Design: Tertiary level, medical‑surgical ICU; prospective, observational study.Results: Patients coming to Medicine Department of the hospital subjected to mechanical ventilation for more than 48 hours in critical Care Facility during the period of two years May 2014 to April 2016.Conclusions: In the incidence of VAP was found to be 78% among ICU patients. Majority (36%) patients had diabetes mellitus, 30% had hypertension before the admission. It is observed that chances of developing VAP were more in patients with co-morbid conditions. The microbiological results of Endotracheal Aspirate showed that, majority 36% had pseudomonas, 26% had Acinetobacter, 22% had no growth, 14% staphylococci (Staphylococcus is a gram-positive, round-shaped bacterium that is a member of the Firmicutes, and is frequently found in the nose, respiratory tract, and on the skin), 2% proteus mirabilis as compared to similar studies. Out of all, Pseudomonas is the most commonly isolated organism. This could be attributed to decreased immunity and a compromised general condition due to associated illness. Also, prolonged hospital stay is also of significance

Prescription audit of patients attendees in public health facilities in Maharashtra, India with special reference to rational use of antibiotics

Background: As soon as a doctor examines the patient, he/she writes the treatment for the illness on a piece of paper and that is called as “Prescription”. Prescription is a document through which doctor, patient and pharmacist are communicated to each other but many a times if these documents are not properly written or misinterpreted it can affect management of patients. World Health Organization (WHO) has established prescribing indicators to analyze the prescription and promoted rational use of drugs and better management of patients. Prescription audit captures the current practices and identifies opportunities for improvement in patient care and along with the mechanisms for realizing them. The main objective is to analyze the prescription of drugs given to the patients in OPD and IPD of the primary and secondary level public health facilities in Maharashtra.Methods: The study was a cross-sectional and observational based on both qualitative and quantitative data. It comprises of secondary data obtained from copies of prescription collected from selected Rural Hospitals (RHs)/Sub-district Hospitals (SDHs) and District Hospitals (DHs)/ Women Hospitals (WHs) of Maharashtra comprising on prescribing practice, rational use of drugs and antibiotics, patient care and facility specific indicators. The Prescribing patterns were analyzed using WHO guidelines with regard to prescribing, patient care and health facility indicators. Qualitative) data collected on perceptions of the patients attending OPD as regard of doctor's consultation and dispensing of medicine; as well as perceptions of pharmacists regarding working environment that measures the ability to prescribe drugs rationally. The copies of the prescriptions from the patients attending OPD / IPD at the above mentioned public health institutions (PHCs, RHs, SDHs and DHs/ DWHs) were obtained. Statistical analysis of study was analyzed using the frequencies and cross tabs by using MS-Office Excel and SPSS Version 20.Results: This exercise showed that there is a scope for improvement in prescribing patterns in areas of writing generic names of drugs, essential drugs, writing legible and complete prescriptions.Conclusions: The present study clearly indicates that there is a great need of interventions like distribution of antibiotic guidelines and running workshops and seminars on rational drug use to prescribers to improve the prescribing behaviour in the state of Maharashtra. This can be enforced through introducing such concepts and those of rational prescribing in curriculum of medical schools. E-prescriptions can be started in E-Aushadhi software with periodic clinical meetings to learn from the evidence.

Effects of ambient air pollution on respiratory health of adults: findings from a cross-sectional study in Chandrapur, Maharashtra, India

Background: Outdoor air pollution and continuous exposure to ambient air pollutants like particulate matter are among the leading contributors to adverse respiratory health outcomes all over the world. This association between air pollution and the impairment of respiratory functions is evident from number of epidemiological studies specific study has been conducted with an objective to evaluate the effects of ambient air pollution on respiratory symptoms and diseases of adults, in Chandrapur district of Maharashtra state in India.Methods: Comparative cross-sectional quantitative study was undertaken in the Chandrapur district with two geographical locations – study and control between August-November 2013. The data included primary data collection from adults to assess the lung function among adults, spirometry test was used to assess lung function. 2400 adults were selected in this study. Epidemiological information was collected from them by administering structured tool (2400) and Lung function test through spirometry (1200). Data was analysed using frequency tables, crosstab analysis and chi-square test to show significance.Results: Higher % of adults in study area (84.1%) had illness episodes (2-4 times or more than 4 times) compared to control area (78.3%).  Statistically significant difference is observed in prevalence symptoms such as Dry Cough, Sneezing, Sore throat, Breathlessness and Asthma by Chi Square test between study and control groups. Statistically significant difference is observed in prevalence symptoms in Sore Throat, Sneezing, Wheeze and Breathlessness by Chi Square test between ≤ 5 km and >5km distance from the industry.Conclusion: There is a significant effect of ambient air pollution on respiratory symptoms of adults with high prevalence of the symptoms in the study area which is the industrial area than the control area. Presence of multiple industries in or near the village is more harmful than the single industry. Additionally, it also shows that the presence of steel, cement and paper industry in or near a village has caused more ill-effects as compared to coal and thermal industry

Comparative bioequivalence studies of tramadol hydrochloride sustained-release 200 mg tablets

Suhas S Khandave1, Satish V Sawant1, Santosh S Joshi1, Yatish K Bansal2, Sonal S Kadam21Accutest Research Laboratories (I) Private Limited, Koparkhirne, Navi Mumbai, Maharashtra, India; 2Ipca Laboratories Limited, Kandivli Mumbai, Maharashtra, IndiaBackground: Tramadol hydrochloride is available as 50 mg immediate-release (IR) and 100 mg, 200 mg, and 300 mg sustained-release (SR) tablets. The recommended dose of tramadol is 50–100 mg IR tablets every 4–6 hours. The tramadol SR 200 mg tablet is a better therapeutic option, with a reduced frequency of dosing, and improved patient compliance and quality of life. The present study evaluated the bioequivalence of a generic tramadol SR 200 mg tablet.Methods: A comparative in vitro dissolution study was performed on the test and reference products, followed by two separate single-dose bioequivalence studies under fasting and fed conditions and one multiple-dose bioequivalence study under fasting conditions. These bioequivalence studies were conducted in healthy human subjects using an open-label, randomized, two-treatment, two-period, two-sequence, crossover design. The oral administration of the test and reference products was done on day 1 for both the single-dose studies and on days 1–5 for the multiple-dose study in each study period as per the randomization code. Serial blood samples were collected at predefined time points in all the studies. Analysis of plasma concentrations of tramadol and O-desmethyltramadol (the M1 metabolite) was done by a validated liquid chromatography-mass spectrometry analytical method. The standard acceptance criterion of bioequivalence was applied on log-transformed pharmacokinetic parameters for tramadol and its M1 metabolite.Results: The ratios for geometric least-square means and 90% confidence intervals were within the acceptance range of 80%–125% for log-transformed primary pharmacokinetic parameters for tramadol and its M1 metabolite in all the three studies.Conclusion: The test product is bioequivalent to the reference product in terms of rate and extent of absorption, as evident from the single-dose and multiple-dose studies. Both the treatments were well tolerated.Keywords: tramadol, multiple-dose, steady state, bioequivalenc

Varadia, a new helicarionoidean semi-slug genus from India’s Western ghats (Stylommatophora: Helicarionoidea)

We here describe a new Indian helicarionoidean genus, Varadia Bhosale & Raheem gen. nov., containing the single species Varadia amboliensis Bhosale, Thackeray, Muley & Raheem gen. et sp. nov. This new semi-slug is endemic to the northern and central Western Ghats and is primarily a forest living species. We describe and figure the shell, reproductive system, radula, spermatophore and external morphology of this new species, and detail its known distribution. We explore its relationships to other helicarionoideans using phylogenetic analyses of DNA sequence data for part of the ribosomal RNA gene cluster and discuss the morphology of the new genus in relation to other, primarily South Indian, helicarionoidean taxa. Based on characters of the reproductive system, particularly the male genitalia and the gametolytic sac, we provisionally place Varadia gen. nov. in the Macrochlamydinae (Ariophantidae). This is consistent with the results of our molecular phylogenetic analyses. The combination of large size, broad, densely tuberculated shell lobes and a shell with ca 4 whorls and a disproportionately large body whorl makes V. amboliensis gen. et sp. nov. unique among the helicarionoidean taxa of the Western Ghats. The new semi-slug is also highly distinctive in the morphology of its male genitalia

Varadia, a new helicarionoidean semi-slug genus from India’s Western ghats (Stylommatophora: Helicarionoidea)

We here describe a new Indian helicarionoidean genus, Varadia Bhosale & Raheem gen. nov., containing the single species Varadia amboliensis Bhosale, Thackeray, Muley & Raheem gen. et sp. nov. This new semi-slug is endemic to the northern and central Western Ghats and is primarily a forest living species. We describe and figure the shell, reproductive system, radula, spermatophore and external morphology of this new species, and detail its known distribution. We explore its relationships to other helicarionoideans using phylogenetic analyses of DNA sequence data for part of the ribosomal RNA gene cluster and discuss the morphology of the new genus in relation to other, primarily South Indian, helicarionoidean taxa. Based on characters of the reproductive system, particularly the male genitalia and the gametolytic sac, we provisionally place Varadia gen. nov. in the Macrochlamydinae (Ariophantidae). This is consistent with the results of our molecular phylogenetic analyses. The combination of large size, broad, densely tuberculated shell lobes and a shell with ca 4 whorls and a disproportionately large body whorl makes V. amboliensis gen. et sp. nov. unique among the helicarionoidean taxa of the Western Ghats. The new semi-slug is also highly distinctive in the morphology of its male genitalia

Effects of ambient air pollution on respiratory health of adults: findings from a cross-sectional study in Chandrapur, Maharashtra, India

Background: Outdoor air pollution and continuous exposure to ambient air pollutants like particulate matter are among the leading contributors to adverse respiratory health outcomes all over the world. This association between air pollution and the impairment of respiratory functions is evident from number of epidemiological studies specific study has been conducted with an objective to evaluate the effects of ambient air pollution on respiratory symptoms and diseases of adults, in Chandrapur district of Maharashtra state in India.Methods: Comparative cross-sectional quantitative study was undertaken in the Chandrapur district with two geographical locations – study and control between August-November 2013. The data included primary data collection from adults to assess the lung function among adults, spirometry test was used to assess lung function. 2400 adults were selected in this study. Epidemiological information was collected from them by administering structured tool (2400) and Lung function test through spirometry (1200). Data was analysed using frequency tables, crosstab analysis and chi-square test to show significance.Results: Higher % of adults in study area (84.1%) had illness episodes (2-4 times or more than 4 times) compared to control area (78.3%).  Statistically significant difference is observed in prevalence symptoms such as Dry Cough, Sneezing, Sore throat, Breathlessness and Asthma by Chi Square test between study and control groups. Statistically significant difference is observed in prevalence symptoms in Sore Throat, Sneezing, Wheeze and Breathlessness by Chi Square test between ≤ 5 km and >5km distance from the industry.Conclusion: There is a significant effect of ambient air pollution on respiratory symptoms of adults with high prevalence of the symptoms in the study area which is the industrial area than the control area. Presence of multiple industries in or near the village is more harmful than the single industry. Additionally, it also shows that the presence of steel, cement and paper industry in or near a village has caused more ill-effects as compared to coal and thermal industry

Vinobot and Vinoculer: Two Robotic Platforms for High-Throughput Field Phenotyping

In this paper, a new robotic architecture for plant phenotyping is being introduced. The architecture consists of two robotic platforms: an autonomous ground vehicle (Vinobot) and a mobile observation tower (Vinoculer). The ground vehicle collects data from individual plants, while the observation tower oversees an entire field, identifying specific plants for further inspection by the Vinobot. The advantage of this architecture is threefold: first, it allows the system to inspect large areas of a field at any time, during the day and night, while identifying specific regions affected by biotic and/or abiotic stresses; second, it provides high-throughput plant phenotyping in the field by either comprehensive or selective acquisition of accurate and detailed data from groups or individual plants; and third, it eliminates the need for expensive and cumbersome aerial vehicles or similarly expensive and confined field platforms. As the preliminary results from our algorithms for data collection and 3D image processing, as well as the data analysis and comparison with phenotype data collected by hand demonstrate, the proposed architecture is cost effective, reliable, versatile, and extendable

Knowledge, Attitude and Practices regarding tuberculosis among slum pockets of western Mumbai: a cross sectional study

Background: Tuberculosis (TB) is a major public health problem prevailing in the rural and urban areas of India. A study was conducted to assess the Knowledge, Attitude, and Practices regarding tuberculosis among slum pockets of western Mumbai. Material and methods: Cross sectional quantitative study conducted using a pre-validated WHO KAP questionnaire. Random walk technique stratified by daytime was used. Descriptive analysis and inferential statistics (Chi-square test) were used. Result: A total of 140 participants were interviewed. Knowledge received from friends, neighbors reported more (58%) in NCC and squatters colony as compared Ambujwadi (48.6%). People held compassion and desire to help people living with TB (59.3%), but only 1.4% participants had reported actual support to TB patients in need. Stigma of TB (80.0%) is one of the most difficult challenges which attributed to hiding of TB disease status. Almost all respondents agreed that people hide TB status because of “fear that people will avoid them”.BMC corporation hospital (82.9 %) is the first choice of health seeking among the study participants however only 7.9 % of people knew about DOTs. Gender (p<0.005) and educational status (p<0.05) were found significantly associated with the knowledge of TB. Conclusion: Knowledge towards tuberculosis within the population is poor. It suggests that specialized educational programs should be developed for community to promote awareness regarding TB. The findings regarding attitude and stigma indicate need to address “stigma related to TB” by health care facilitators and community people at the time of health education