Assessment of knowledge & practice of contraceptives in females of reproductive age group at a tertiary care hospital

Abstract Objectives: To assess the knowledge & practice of contraceptives in females of reproductive age group.Study Design: Cross sectional descriptive. Place and Duration of Study: OPD of Fauji Foundation Hospital from February 2008 – September 2008.Subjects and Method: 339 Females of age b/w of 15 – 49 years attending OPD of Fauji Foundation Hospital were included in study. A structured questionnaire was used to collect data.Results: Eighty eight percent of the females in our study sample were familiar with one or more methods of contraception (72.7%were familiar with combined oral contraceptive pill (COCP), 60.7% were aware of intra uterine contraceptive device (IUCD) &76% knew about condoms) whereas 12% showed ignorance. 64.6% of the study population was contraceptive users & 35.4% were not using any method of contraception. Regarding preferred method of contraception 34.6% of females said they are using COCP, about 21.8% females said their tubes had been liagated whereas 26.9%& 16.7% were using IUCD & Condoms respectively. Almost 46%of our study population said that contraceptive method they were using was suggested by their husbands, 44 % said by health professional .Only 10 % of the study population were using a method of their own choice.Conclusion: The present study concludes that there is a gap between knowledge (88%) and use (64.6%) of contraceptives among females of reproductive age group. Another important inference drawn from the study is that men should be made equal targets of such programs in since 46% females in our study population were using method of contraceptive suggested by their husban

Addressing Resistance to Antibiotics in Pluralist Health Systems

There is growing international concern about the threat to public health of the emergence and spread of bacteria resistant to existing antibiotics. An effective response must invest in both the development of new drugs and measures to slow the emergence of resistance. This paper addresses the former. It focuses on low and middle-income countries with pluralistic health systems, where people obtain much of their antibiotics in unorganised markets. There is evidence that these markets have enabled people to treat many infections and reduce mortality. However, they also encourage overuse of antibiotics and behaviour likely to encourage the emergence of resistance. The paper reviews a number of strategies for improving the use of antibiotics. It concludes that effective strategies need measures to ensure easy access to antibiotics, as well as those aimed at influencing providers and users of these drugs to use them appropriately.Funding for work on this paper was provided by a grant by the UK ESRC to the STEPS Centre and a grant by the UK Department for International Development to the Future Health Systems Consortium

Malaria Prevalence in Endemic Districts of Bangladesh

BACKGROUND: Following the 1971 ban of DDT in Bangladesh, malaria cases have increased steadily. Malaria persists as a major health problem in the thirteen south-eastern and north-eastern districts of Bangladesh. At present the national malaria control program, largely supported by the Global Fund for AIDS, Tuberculosis and Malaria (GFATM), provides interventions including advocacy at community level, Insecticide Treated Net (ITN) distribution, introduction of Rapid Diagnostic Tests (RDT) and combination therapy with Coartem. It is imperative, therefore, that baseline data on malaria prevalence and other malaria indicators are collected to assess the effectiveness of the interventions and rationalize the prevention and control efforts. The objective of this study was to obtain this baseline on the prevalence of malaria and bed net use in the thirteen malaria endemic districts of Bangladesh. METHODS AND PRINCIPAL FINDINGS: In 2007, BRAC and ICDDR,B carried out a malaria prevalence survey in thirteen malaria endemic districts of Bangladesh. A multi-stage cluster sampling technique was used and 9750 blood samples were collected. Rapid Diagnostic Tests (RDT) were used for the diagnosis of malaria. The weighted average malaria prevalence in the thirteen endemic districts was 3.97%. In five south-eastern districts weighted average malaria prevalence rate was 6.00% and in the eight north-eastern districts weighted average malaria prevalence rate was (0.40%). The highest malaria prevalence was observed in Khagrachari district. The majority of the cases (90.18%) were P. falciparum infections. Malaria morbidity rates in five south-eastern districts was 2.94%. In eight north-eastern districts, morbidity was 0.07%. CONCLUSION AND SIGNIFICANCE: Bangladesh has hypoendemic malaria with P. falciparum the dominant parasite species. The malaria situation in the five north-eastern districts of Bangladesh in particular warrants urgent attention. Detailed maps of the baseline malaria prevalence and summaries of the data collected are provided along with the survey results in full, in a supplemental information

Quantifying primaquine effectiveness and improving adherence: a round table discussion of the APMEN Vivax Working Group.

The goal to eliminate malaria from the Asia-Pacific by 2030 will require the safe and widespread delivery of effective radical cure of malaria. In October 2017, the Asia Pacific Malaria Elimination Network Vivax Working Group met to discuss the impediments to primaquine (PQ) radical cure, how these can be overcome and the methodological difficulties in assessing clinical effectiveness of radical cure. The salient discussions of this meeting which involved 110 representatives from 18 partner countries and 21 institutional partner organizations are reported. Context specific strategies to improve adherence are needed to increase understanding and awareness of PQ within affected communities; these must include education and health promotion programs. Lessons learned from other disease programs highlight that a package of approaches has the greatest potential to change patient and prescriber habits, however optimizing the components of this approach and quantifying their effectiveness is challenging. In a trial setting, the reactivity of participants results in patients altering their behaviour and creates inherent bias. Although bias can be reduced by integrating data collection into the routine health care and surveillance systems, this comes at a cost of decreasing the detection of clinical outcomes. Measuring adherence and the factors that relate to it, also requires an in-depth understanding of the context and the underlying sociocultural logic that supports it. Reaching the elimination goal will require innovative approaches to improve radical cure for vivax malaria, as well as the methods to evaluate its effectiveness

Reinforcement of Lime Ash Particles in LDPE

This study presents findings from an experimental investigation on the reinforcement of Lime ash particles (LAP) synthesized from coal fly ash, CaO, and CaSO4 in Low density Polyethylene (LDPE).The Lime ash particles are synthesized by reinforcing 0 to 30 weight percentages of LAP in virgin LDPE using compression moulding. The mechanical properties of composites are studied and results showed that by adding LAP in LDPE as filler the Tensile Strength and Impact Strength of the composite decreases due to poor interfacial bonding between filler particles and LDPE but Hardness and Flexural Properties increases due to improved properties of surface