Potentials, Experiences and Outcomes of a Comprehensive Community Based Programme to Address Malnutrition in Tribal India

This paper demonstrates the effect of an innovative community-based management programme on acute malnutrition among children under three years of age, through an observational longitudinal cohort study in tribal blocks in central-eastern India. The key components of the programme include child care through crèches, community mobilisation and systems strengthening to ensure better child feeding and caring practices and delivery of public health and nutrition services. For a cohort of 587 children, the increase in children in the non-wasting category is from 72% to 80% (p<0.001) and the reduction in Severe Acute Malnutrition (SAM) from 8% to 4% (p<0.005), a reduction of 46.6%. Normalcy is fairly well maintained at 89%. Among the severely wasted, 16% show no improvement, 49% moved into a moderate wasting category and 36% to normalcy over 4-6 months. Among the moderately wasted, 26% showed no improvement and 7% declined to a severely wasted category, and 67% moved to normalcy. The average Weight for Height Z-score (WHZ) for the cohort improved from -1.41 in the initial period to -1.13 in November (p<0.0001). This study suggests that this medium term strategy using a rights-based participatory approach for community based management of malnutrition may be comparatively effective by current WHO guidelines and other known community based interventions in terms of mortality, cost, degree and pace of improvements

A study to understand the barriers and facilitating factors for accessing health care amongst adult street dwellers in New Delhi, India

Master of Public Health - MPHUrban health policy has remained a neglected area in India. The homeless remain the most deprived, neglected and stigmatized group amongst the urban poor. While they suffer from a large burden of disease, there are a variety of reasons that prevent them from accessing the available health care services – particularly in the public health sector. Some interventions by concerned non-governmental organisations have attempted to circumvent the barriers to health care access faced by the homeless but these have not been well documented or assessed. This study seeks to establish both the barriers and facilitating factors for access to health care and health care seeking amongst adult street dwellers in an area of New Delhi which is known for a high concentration of homeless persons. Using a qualitative approach 18 adult street dwellers (both male and female) were individually interviewed – along with 6 key informants working in the public and non-governmental health sector. This was accompanied by a process of participant-observation. The results were analyzed by identifying recurrent themes associated with barriers and facilitating factors for access to health care by the homeless, following which a set of recommendations related to the homeless, have been developed so as to inform those working in the public health sector. In terms of ethics, informed consent was taken from each interviewee and they were explicitly given the option not to participate without adverse consequences to themselves. If any participant was found with acute health problems immediate assistance was facilitated. The study reveals a number of barriers faced by the homeless in attempting to access health care services. While minor ailments are taken care of by local private practitioners, they need to access public health care services for major problems. There they encounter many barriers due to the lack of money, delays and being shunted from place to place. Moreover, they are not able to get admission for reasons such as lack of address and the lack of an attendant. Facilitating factors include assistance for transportation, facilitation of admissions, arranging money for out of pocket expenditures on drugs and consumables, arranging blood and providing after-care. The role of social contacts in enabling access is also demonstrated through this study. The recommendations that emerge from the study are intended to assist in policy advocacy towards a comprehensive health care system for them, as well as assist health care providers to provide a better service for homeless people

Empowering health personnel for decentralized health planning in India: The Public Health Resource Network

The Public Health Resource Network is an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level, to improve accountability of health systems, elicit community participation for health, ensure equitable and accessible health facilities and to bring about convergence in programmes and services

IN VITRO EVALUATION OF LECTINIZED CISPLATIN BEARING LIPOSOMES SYSTEM

Objective: The purpose of this study was to evaluate the extent and mechanism anti-cancer drug-loaded liposomes using wheat germ agglutinin as a guiding molecule. Methods: For the drug-loaded liposome synthesis, the thin film hydration method was used and the drug cisplatin was loaded during the synthesis and followed by the surface modification using wheat germ agglutinin (WGA) lectin. The developed system was confirmed based on transmission electron microscopy (TEM), atomic force microscopy (AFM), particle size (PS) analyzer, polydispersity index and Zeta Potential analyzer. Results: The results showed the surface modified by liposomes had the particle size 200±5 nm. The wheat germ agglutinin coated on the surface to liposome led to a reduction in zeta potential and drug entrapment efficiency while particle size increased. Plain liposomes containing cisplatin had less effect than WGA modified liposome on MCF-7 cell lines. Conclusion: The MTT studies indicated that the drug molecules were initially get delivered to the inside the cell. This formulation offered new simple approach and effectively kill the cells via targeting the nucleus

Mid-Late Holocene climatic variations in Trans-Himalaya, Ladakh, NW India

Abstract HKT-ISTP 2013 B

REDUCED SUSCEPTIBILITY OF MRSA TO VANCOMYCIN

Objective: This study was conducted to observe the antibiogram, vancomycin MIC (Minimum Inhibitory Concentration), and inducible clindamycin resistance in clinical isolates of MRSA (Methicillin-Resistance Staphylococcus aureus).Methods: Drug resistance pattern was studied by Kirby-Bauer disc diffusion methods. MIC of vancomycin was determined by agar dilution method.Results: MRSA was found to be highly resistant to gentamicin (76%), erythromycin (67.03%) and ciprofloxacin (65.09%) while glycopeptides showed uniform susceptibility.Conclusion: Though there was no drug resistance observed against vancomycin and linezolid, it's wise to use these antibiotics safely as emerging resistance has been reported for these drugs from all over the world

Adenosarcoma of uterus in mother and mucinous carcinoma of breast in daughter: a rare case study

Adenosarcoma is an infrequent malignancy which consists of benign glandular epithelium and malignant mesenchymal component. We report a 63-year-old woman diagnosed with adenosarcoma with sarcomatous overgrowth of the uterine corpus, with history of mucinous carcinoma of the breast in her daughter. Although endometrial and breast cancers share few similar hormonal, reproductive and genetic risk factors, the association of endometrial cancer with breast carcinoma is not well established. 63 years old, P4L4, postmenopausal lady presented to our hospital with post-menopausal spotting, foul smelling vaginal discharge and pain abdomen for 1 week. After evaluation she underwent total abdominal hysterectomy with bilateral salpingo-oopherectomy. Intraoperatively, a pedunculated fundal polyp measuring 6×7 cm distending the uterine cavity was noted. Post-operative histopathology examination was reported as adenosarcoma with sarcomatoid overgrowth of the uterine cavity. Immunohistochemistry revealed CK7 (epithelium (+), Vimentin (+), cluster of differentiation 10 (CD10) (+) and, Wilms tumor 1 (-). The possible association between these two conditions, adenosarcoma of uterus in mother and mucinous carcinoma of breast in daughter is explored and presented in this case report