REASONS FOR PATIENT DELAYS & HEALTH SYSTEM DELAYS FOR TUBERCULOSIS IN SOUTH INDIA

Background: Globally, the burden of Tuberculosis is escalating. Early diagnosis and prompt initiation of tuberculosis treatment is essential for an effective tuberculosis control programme. Objectives: To study the self reported reasons for patient and health system (diagnosis & treatment) delays in Tuberculosis patients. Methods: A community based cross sectional study was conducted among 98 new sputum positive TB cases aged > 15 years registered under RNTCP from Oct 2006 to June 2007 & receiving treatment under DOTS in Udupi taluk by interviewing them. Results: Total 98 patients were recruited and 68% were males. Out of 17 patients with patient delays, 82% felt that their symptoms were not severe, 71% felt that patient delay was due to lack of awareness and 71% did not take it seriously. Out of 86 patients with health system delays, 82.6% of patients mentioned that doctor has not advised for sputum examination, 76.7% of patients told that they first consulted a private doctor, 21% of them mentioned that doctor was unaware to diagnose TB. Conclusion: Symptoms not severe is the main reason for the patient delay and doctor didn’t advise for sputum examination is the main reason for health system delays

THE SOCIAL AND OCCUPATIONAL HEALTH PROBLEMS OF CHILD LABOUR: A CHALLENGE THE WORLD IS FACING

Eliminating child labour is one of the biggest challenges that the world is facing. Child labour not only causes damage to a child’s physical and mental health but also keeps him deprived of his basic rights to education, development, and freedom. Children of lower socio-economic class are known to be inducted as child labour. The main causes of child labour include poverty, unemployment, excess population and urbanization. The construction sector is one of the most hazardous working environments especially for children. Children are exposed to dangerous machinery causing fatal and non-fatal injuries, while operating or working near them. Children are exposed to strenuous labour, which can affect the musculo-skeletal development of the children. In industries, child workers are exposed to various physical, mental, social occupational hazards resulting in lower growth and poor health status. Working long hours, child labourers are often denied a basic school education, normal social interaction, personal development and emotional support from their family. The Child Labour Act was implemented in India in 1986 that outlaws child labour in certain areas and sets the minimum age of employment at fourteen. Eradicating poverty is only the first step on the road for eliminating child labour. There is an urgent need for intensive focus and research along with political and practical decisions to improve the conditions of working children for the betterment of their health and development. Proper education of the children and banning child labor will help in boosting the success of the country

Alcohol and Tobacco Use Among Undergraduate and Postgraduate Medical Students in India: A Multicentric Cross-sectional Study

Background: Substance use among medical fraternity is a well-known phenomenon among both undergraduate (UG) and postgraduate (PG) medical students. Yet, there have been very few multi-centric studies to estimate the actual burden of this problem in this important population group in India. This study was conducted to estimate the prevalence of alcohol and tobacco use, assess the knowledge and attitudes towards this issue, and identify factors associated with substance use among UG and PG medical students in India.Methods: A pre-tested, self-report, anonymous questionnaire was administered to medical undergraduates and post graduate medical residents of eight medical colleges across India. This study used a convenience sample of medical colleges with random selection of study participants within each college for each group, UG and PG.Results: Prevalence of alcohol and tobacco use among UG students was 16.6%, 95% CI [14.5, 18.9] and 8.0%, 95% CI [6.4, 9.6], respectively, whereas prevalence was 31.5%, 95% CI [26.3, 37.0] and 14.5%, 95% CI [10.7, 18.9], respectively for PGs. For both substances, males had a higher prevalence of use compared to females in both groups (p < 0.001). Positive family history of substance use (p < 0.001 for both groups) and early age of initiation (p = 0.011 for tobacco; p > 0.05 for alcohol) were associated with a greater difficulty to quit the habit. Over 90% of study participants felt that substance use adversely affected their skills and reported not using substances prior to managing their patients.Conclusions: Since substance use is a relatively common phenomenon among UG and PG medical students in India, future prospective studies and interventions are required to better understand the pattern of substance use and reduce its prevalence.

Effect of digitization of medical case files on doctor patient relationship in an Out Patient Department setting of Northern India: A comparative study

Background: Digitization of health records and health delivery processes in health care settings may have an impact on the Patient-Physician communication, wait times, that affect the overall patient satisfaction with the health care services. Aim & Objective: We ascertained the effect of digitization of medical case files on the doctor patient relationship (DPR) domain of patient satisfaction at an urban primary health center in India. Settings and Design: Comparative, cross-sectional study in primary health centres. Methods and Material: The patient satisfaction was compared between the patients attending the Public Health Dispensary (PHD) that uses digitized medical case file system and a Civil Dispensary (CD) which follows the conventional paper based medical records, using a Patient Satisfaction Questionnaire (PSQ). Statistical analysis used: Univariate analysis was done by chi-square test and adjusted analysis was done by multiple linear regression. Results: Patient satisfaction in DPR was found to be same between the digitized medical case files based and conventional OPD (p=0.453). Significantly higher overall patient satisfaction was reported in the conventional paper based OPD than the digitized OPD (p<0.001). Conclusions: Patient satisfaction towards the doctor-patient relationship (DPR) was same between paper based OPD and the digitized medical case files based OPD

Ameliorative effect of Albizzia procera leaves extract against experimentally induced gastric ulcer models in Wistar albino rats

Albizzia procera belongs to family Fabaceae and has several phytoconstituents like flavonoids, terpenes, alkaloids, saponins etc. The plant is commonly used in traditional medicines. The objective of the present study was to assess the ameliorative effect of A. procera leaves extract against an experimentally induced gastric ulcer in albino rats. The antiulcer, antisecretory and cytoprotective properties of an ethanolic extract prepared from the leaves was evaluated. When given in a 200 mg/kg oral (per. os) dose, the extract produced 74% and 85% protection index in ethanol-induced ulcer model and pylorus ligation model, respectively.  Additionally, the extract also prohibited the formation of haemorrhage and edema, significantly lessened catalase activity (p<0.0001) and the lipid peroxidation level (p<0.0001) in the glandular tissue of Wistar albino rats. Furthermore, the extract also significantly diminished the total acidity(p<0.0001) of the gastric fluid by increasing its pH (p<0.0001). The occupancy of different phytoconstituents in the extract, such as flavonoids and tannins were identified that may be responsible for its gastro-protective activity. All these results provide a basis explaining the antiulcer ability of A. procera being useful in the management of gastric ulcers

Evaluation of antioxidant potential of alcoholic stem bark extracts of Bauhinia variegata Linn.

The present study was carried out for the evaluation of in-vitro antioxidant potential of alcoholic stem bark (ALSB) extract of Bauhinia variegata Linn. Dried stem bark extract of B. variegata Linn. was screened to evaluate its free radical scavenging effect. Various methods like DPPH assay, reducing power assay, percentage scavenging activity of hydrogen peroxide and superoxide radical scavenging activity were used for screening in-vitro antioxidant potential. Antioxidant potentials were concentration dependent which were compared with standard antioxidants such as butylated hydroxyanisole (BHA) and ascorbic acid. The maximum scavenging effect of B. variegata Linn. alcoholic stem bark extract on  DPPH free radical, superoxide radical and hydrogen peroxide was 72.19 + 0.20, 81.60 + 0.22 and 76.06 + 0.16 respectively at a concentration of 2500 ?g/mL.  It was clearly indicated that the alcoholic extract of the stem bark has significant in vitro antioxidant activity. Currently available synthetic antioxidants like butylated hydroxyanisole (BHA), butylated hydroxyl toluene (BHT), Ascorbic acid and gallic acid appear to be associated with hepatotoxicity and many others negative health effects. Therefore, natural antioxidants may be preferred over the synthetic antioxidants

The Capacity of Multi-Hop Wireless Networks with TCP Regulated Traffic

We study the capacity of multi-hop wireless networks with TCP regulated traffic. We study the dependence of the capacity on the transmission range of nodes in the network. Specifically, we examine the sensitivity of the capacity to the speed of the nodes and the number of TCP connections in an ad hoc network. By incorporating the notion of a minimal acceptable QoS metric (loss) for an individual session, we argue that the QoS-aware capacity is a more accurate model of the TCP-centric capacity of an ad-hoc network. We study the dependence of capacity on the source application (Telnet or FTP) and on the choice of the ad-hoc routing protocol (AODV, DSR or DSDV). We conclude that persistent and non-persistent traffic behave quite differently in an ad-hoc network

PCM-assisted energy storage systems for solar-thermal applications: Review of the associated problems and their mitigation strategies

Latent heat energy storage (LHES) system is identified as one of the major research areas in recent years to be used in various solar-thermal applications. However, there are various challenges associated i.e., low thermal conductivity, leakage issues, stabilization concerns, etc. In this work, a comprehensive review of studies dealing with these problems and their mitigation strategies. Various design parameters influencing the performance of PCM-assisted systems are also discussed. This article further presents a detailed review of several mathematical models, based on system enthalpy and heat capacity-based modeling schemes along with the techno-economic analysis. The review results reflect the application of porous foams increasing thermal conductivity values of PCM composites relative to pure PCM working mediums. Moreover, the use of extended surfaces with appropriate geometries reduces the phase transition durations for the working medium significantly which enhances the thermal performance. Additionally, PCM encapsulations are identified as one of the widely accepted procedures intensifying the thermal performance of energy storage systems. However, the selection of appropriate encapsulation shell material and shell geometries are some of the important factors to be considered to ensure optimum system performance. This review focuses on the significant aspects of PCM encapsulation design parameters for several solar-thermal systems

A multi-targeted approach to suppress tumor-promoting inflammation

Cancers harbor significant genetic heterogeneity and patterns of relapse following many therapies are due to evolved resistance to treatment. While efforts have been made to combine targeted therapies, significant levels of toxicity have stymied efforts to effectively treat cancer with multi-drug combinations using currently approved therapeutics. We discuss the relationship between tumor-promoting inflammation and cancer as part of a larger effort to develop a broad-spectrum therapeutic approach aimed at a wide range of targets to address this heterogeneity. Specifically, macrophage migration inhibitory factor, cyclooxygenase-2, transcription factor nuclear factor-κB, tumor necrosis factor alpha, inducible nitric oxide synthase, protein kinase B, and CXC chemokines are reviewed as important antiinflammatory targets while curcumin, resveratrol, epigallocatechin gallate, genistein, lycopene, and anthocyanins are reviewed as low-cost, low toxicity means by which these targets might all be reached simultaneously. Future translational work will need to assess the resulting synergies of rationally designed antiinflammatory mixtures (employing low-toxicity constituents), and then combine this with similar approaches targeting the most important pathways across the range of cancer hallmark phenotypes