Delay in DOTS for new pulmonary tuberculosis patient from rural area of Wardha District, India

Vast majority of active tuberculosis patients seeks treatment, do so promptly, still many patients spend a great deal of time and money “shopping for health” and too often they do not receive either accurate diagnosis or effective treatment, despite spending considerable resources. Objective: To find out the time taken to, for diagnosis of tuberculosis and to put patient on DOTS from the onset of symptoms and pattern of health seeking behavior of new pulmonary tuberculosis patients. A cross-sectional rapid assessment using qualitative (FGD) and quantitative (Interview) methods conducted at DOTS center of tertiary care hospital from rural Wardha. Participants: 53 pulmonary tuberculosis patients already on DOTS, in intensive phase. Main outcome measure: Delay in initiation of DOTS & health seeking behavior Results: Median total delay for starting DOTS was 111 days, (range: 10 to 321 days). Patient delay was more than provider delay. Patients delay was more in patients above 60 years, illiterate, per-capita income below 650 Rupees and HIV TB co-infection. Pattern of health seeking behavior was complex. Family physician was the preferred health care provider. Patient visited on an average four providers and spent around 1450 rupees (only direct cost) before DOTS begin. Time taken from the onset of symptoms and start of DOT is a cause of concern for the tuberculosis control program. Early case detection is important rather than mere achieving target of 70% new case detection. Program manager needs to implement locally relevant & focused strategies for early case detection to improve the treatment success, especially in rural area of India

Biosecurity of Poultry Worker Related to Avian Influenza in Bangladesh

Research on biosecurity of poultry workers of Live Bird Market (LBM) in urban and rural areas related to highly pathogenic avian influenza (AI) was undertaken during March-June, 2014 at Keshabpur upazila (22°48´-22°57´N latitude and 89°06´-89°22´E longitude), Jessore, Bangladesh. A non-randomized (purposive) sampling method was applied and a descriptive type of cross sectional study was performed among 72 workers, dividing them into two groups as 36 urban and 36 rural poultry workers of LBM through split-halves variation technique. They were interviewed confidentially in their work place using a structured pretested questionnaire. Among respondents 53%, 75%, 45%, 81%, and 56% of urban and 50%, 42%, 50%, 89%, and 36% of rural residence had attended up to primary school, knowledge about AI through media like TV and radio, used proper personal protective equipment as mask and gloves, washed their hands and equipment after finishing work and cleaned stalls/cages daily and mostly they used water as a cleaning material, respectively. In urban (14%) and rural (36%) workers used the same vehicle to transport poultry and humans. A combined effort is required to enhance knowledge and change behavior among those most at risk in low-income countries and precautions necessary to avoid spreading the virus among poultry and humans

A REVIEW ON COVID-19-A GLOBAL BATTLE BETWEEN LIFE AND DEATH

Currently, the globe is affected by a severe pandemic scenario of COVID-19 infection. The Covid-19 infectious disease is spreading everywhere on the globe particularly in developed countries like China, u. s. Italy, France, Spain, Iran, England, Germany, South Korea, etc. a deadly disease of a unique coronavirus (COVID‐19 or 2019‐CoV) infection has exhibited significant threats to global health, and also the economy. Following an outbreak of pneumonia without a transparent cause within the city of Wuhan in China, a novel strain of coronavirus (2019-nCoV) was detected in December 2019. Coronavirus is called for the spikes that protrude from their membranes just like the sun's corona. In line with WHO, Common signs of infection embrace fever, cold, cough, and respiratory difficulties like dyspnea, pneumonia. Within the absence of treatment for this virus, there's an imperative got to notice various strategies to manage the unfold of disease. It's “Corona time,” however; unfortunately, it's the virus that we tend to speak. In this paper, the origin of the viral infection, the clinical characteristics of Covid-19, etiology, pathogenesis, symptoms treatment and hindrance of Covid-19 are comprehensively detailed. At the time of this writing there are more queries than answers. The aim of our article is to provide a comprehensive understanding of COVID-19 to the peoples, so they'll better understand it and prevent it

Comparative study to evaluate efficacy and safety of azilsartan and telmisartan in patients with grade I-II essential hypertension

Background: Objectives of the study was to study the effect of Azilsartan 40mg once daily versus Telmisartan 40mg once daily in patients with Grade I-II essential hypertension.Methods: A prospective study was conducted at MGM Medical college and Hospital which included 80 patients in each group with Grade I–II essential hypertension. The sex, age, presenting illness, and family history of the patients were recorded. Investigations such as blood sugar, urine analysis, kidney function test, lipid profile, and ECG were performed before starting the treatment. Any adverse effects during the treatment were noted. Blood pressure was recorded at baseline and during follow-up. One group received Azilsartan 40mg once daily and another group Telmisartan 40mg once daily. Patients were followed-up every week for 5 weeks.Results: Patients receiving Azilsartan 40mg and Telmisartan 40mg showed a significant fall (P 0.05). Adverse effects such as Nasopharyngitis, Upper respiratory tract inflammation, Gastroenteritis, headache, dizziness, and fatigue were reported with both drugs.Conclusions: Reduction of blood pressure with Azilsartan and Telmisartan was similar, but fall in blood pressure from baseline was highly significant in both groups

Hypersensitivity reactions to intravenous ferric carboxymaltose in a patient with iron deficiency anemia: a rare case report

Ferric carboxymaltose (FCM) is a non-dextran iron preparation recently approved in the United States for intravenous treatment of iron deficiency anemia (IDA) in adult patients with intolerance or poor response to oral iron therapy. Acute hypersensitivity reactions (HSRs) during iron infusions are very rare but can be life-threatening. Adverse events, including immune system disorders (0% in FCM) and skin disorders (7.3% in FCM), are less frequently observed with FCM. On treatment with FCM, the change in hemoglobin from baseline to the highest observed level is about 2.8g/dL. Treatment of IDA with FCM resulted in fewer hypersensitivity reactions. Here, authors report a case of a 23 years old female diagnosed for IDA presented with the picture of adverse drug reaction due to injection FCM given by the physician. The patient was managed with Antibiotics, Corticosteroids and Intravenous fluids and recovered well within 12 hours of admission from this adverse drug reaction. Since such cases have been rarely reported, authors are intended to notify about this potentially dangerous drug reaction due to FCM which is used extensively in the treatment of IDA. Hence management of iron infusions requires very careful and precise observation, and, in the event of an adverse reaction, prompt recognition and severity-related interventions by well-trained medical and nursing staff

Prospective study on quality of newborn care

Background: Quality of services provided by health care provider, the closest health functionary to the community has impact on neonatal mortality. Aims: Study on quality of newborn care in rural areas.  Settings and Design: This is a prospective study in the field practice areas of J.N. Medical College and areas under primary health centre of public health care system in Wardha district.  Methods and Material: Modified quality check list on the basis of PHC MAP module guidelines for assessing the quality of service-module 6-user’s guide was prepared. Face to face interview with 205 (group-A/104 nos + group-B/101 nos) mother of newborn was method to collected information in three postnatal visits.  Statistical analysis: Quality (verbal response) of each service was quantified as acceptable, average and worst.  Quality of both the groups was compared by calculating P-value after utilizing Z-test.  Results: Over all acceptable quality of medical history was 30.03%, physical examination was 21.73%, preventive service was 91.17% and counseling was 24.83%. Significant difference between two groups were found on history taking for (cry, breathing and body movement of baby), recording weight and counseling regarding exclusive breast feeding for first 6 month of life. Worst quality in this study were observed in history for anything applying to eyes, umbilical cord stump and complication of baby for which appropriate management was taken. Except for weight recording and examination of head and fontanels all other variables under physical examination were not acceptable. Counseling regarding high risk condition of baby was only 13.66%. Conclusion: Existing newborn services except immunization is inadequate and needs to be strengthened especially physical examination and counseling services

Ghrelin for the management of cachexia associated with cancer

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the efficacy and safety of ghrelin on improving food intake, body composition and survival in patients with cachexia associated with cancer. © 2016 The Cochrane Collaboratio

Surgico-therapeutic management of thoroughpin in two Camels (Camelus dromedarius)

Abstract Tenosynovitis of the tarsal sheath is called thoroughpin of tarsal sheath. It is common in horses but in present report it is found in two camels. One camel respond to injection of corticosteroid into the cavity of the tarsal sheath but other did not, therefore surgical approach was determined. There was a remarkable improvement in the swelling as well as degree of lameness after surgery