New HIV Prevention Technologies: Knowledge and Perceived Usage by HIV-discordant and Concordant Couple with Risk Behaviour a Qualitative Study in Tamil Nadu. India

New HIV prevention technologies include vaccines, microbicides, female condoms and others that may also provide protection from unplanned pregnancy and sexually transmitted infections (STIs). A qualitative study was conducted among HIV-discordant and HIV- concordant couples who were selected purposively from December 2012 to June 2014.  The data were collected through in-depth interviews with HIV- discordant couples (n=8) and HIV- concordant couples (n=8). The couples were aware of all the risks involved in not using any prevention methods; some of them were able to mention about what they understood about a particular method, its usage, harm in not using, its availability and Government’s role in promotion. The couples provided information on their understanding, availability and usage of male and female condoms, microbicides and HIV vaccine, their belief on male circumcision and views on PrEP. Their requirements for new prevention technology (NPT) and multiple prevention technology (MPT) were also elicited. Thecouples with risk behavior preferred having MPT that would prevent pregnancy, STIs and HIV, which would be of good quality, easily available and accessible. Keywords: New HIV prevention technology, Microbicide, Pre-Exposure Prophylaxi

Performance evaluation and statistical analysis of saw dust as concrete

The utilization of industrial by products instead of the cementitious materials in concrete leads to sustainable environment and helps to reduce the environmental pollution. This part of the research concentrates on the performance evaluation of Saw Dust Ash (SDA) as a partial replacement for cement as well as the regression analysis among different parameters. It includes the setting time, fresh concrete properties and hardened concrete properties of the saw dust ash concrete. SDA was used by weight from 5% to 20% in steps of 5% to replace ordinary Portland cement. The fresh concrete properties indicate that the workability of SDA concrete decreases as the percentage replacement of SDA increases. The compressive strength, flexural and split tensile strength of the hardened concrete increases up to 10% of saw dust ash and then decreases. It is concluded that the optimum percentage to replace cement with saw dust ash is up to 10% for the reliable results. Further replacement would be detrimental to the strength of the concrete. The regression analyses to predict split tensile strength and flexural strength with respect to compressive strength shows very good correlation with regression coefficients of 0.979 and 0.911 respectively. The saw dust ash concrete was also found to be cheaper and friendlier to the environment than Portland cement concrete in the proportion to the percentage of cement replaced

Performance evaluation and statistical analysis of saw dust as concrete

The utilization of industrial by products instead of the cementitious materials in concrete leads to sustainable environment and helps to reduce the environmental pollution. This part of the research concentrates on the performance evaluation of Saw Dust Ash (SDA) as a partial replacement for cement as well as the regression analysis among different parameters. It includes the setting time, fresh concrete properties and hardened concrete properties of the saw dust ash concrete. SDA was used by weight from 5% to 20% in steps of 5% to replace ordinary Portland cement. The fresh concrete properties indicate that the workability of SDA concrete decreases as the percentage replacement of SDA increases. The compressive strength, flexural and split tensile strength of the hardened concrete increases up to 10% of saw dust ash and then decreases. It is concluded that the optimum percentage to replace cement with saw dust ash is up to 10% for the reliable results. Further replacement would be detrimental to the strength of the concrete. The regression analyses to predict split tensile strength and flexural strength with respect to compressive strength shows very good correlation with regression coefficients of 0.979 and 0.911 respectively. The saw dust ash concrete was also found to be cheaper and friendlier to the environment than Portland cement concrete in the proportion to the percentage of cement replaced

Vascular complications in long-term South Indian NIDDM of over 25 years' duration

The prevalence of vascular complications was assessed in 726 South Indian non-insulin dependent diabetes mellitus (NIDDM) patients with over 25 years' duration of diabetes. Retinopathy was detected in 52.0% of patients which included 41.7% with non-proliferative and 10.3% with proliferative diabetic retinopathy. Nephropathy was present in 12.7% and neuropathy in 69.8% of patients. While 32.8% of patients had ischaemic heart disease, the prevalence of peripheral vascular disease was only 15.4%. Multivariate logistic regression analyses showed that serum creatinine was associated with retinopathy, creatinine and post-prandial plasma glucose with nephropathy and post-prandial plasma glucose and age with neuropathy. This is one of the first reports on vascular complications in long-term diabetes from the Indian sub-continent

Clinical profile of lean NIDDM in South India

The majority (>80%) of patients with non insulin dependent diabetes mellitus (NIDDM) present in Europe and America are obese. In developing countries like India, most NIDDM (>60%) are non-obese and many are actually lean with a body mass index (BMI) of <18.5 and are referred to as `lean NIDDM'. This paper compares the clinical profile of a cohort of 347 lean NIDDM, with a group of 6274 NIDDM of ideal body weight (IBW) and 3252 obese NIDDM attending a diabetes centre at Madras in South India. The lean NIDDM who constituted 3.5% of all NIDDM patients seen at our centre, had more severe diabetes and an increased prevalence of retinopathy (both background and proliferative), nephropathy and neuropathy. Although a larger percentage of the lean NIDDM patients were treated with insulin, 47% of the males and 53% of the females were still on oral hypoglycaemic agents even after a mean duration of diabetes of 9.2±8.1 years. Studies of GAD antibodies, islet cell antibodies (ICA) and fasting and stimulated C-peptide estimations done in a small subgroup of the lean NIDDM showed that they were distinct from IDDM patients. More studies are needed on metabolic, hormonal and immunological profile of lean NIDDM seen in developing countries like India

Performance of recycled Bakelite plastic waste as eco-friendly aggregate in the concrete beams

The use of plastic waste as a partial or complete replacement for coarse aggregate in concrete mixtures has been studied in recent years. However, the quality and quantity of coarse plastic waste particles have been a challenge. This study aims to investigate the mechanical performance of concrete with Bakelite plastic waste as a partial replacement for coarse aggregate. Six different concrete mixtures with various Bakelite dosages, ranging from 0 % to 10 %, were tested. The results indicate that the addition of Bakelite plastic alters the behaviour of the concrete and reduces compressive and flexural strengths at lower dosages. The inclusion of Bakelite waste in concrete mixtures generally leads to a decrease in compressive and split tensile strength, with the exception of the mixture containing 6 % Bakelite, which showed increased strength. Although there is a slight reduction in flexural strength, Bakelite waste prevents sudden specimen breakage and maintains specimen integrity. The ultimate load capacity of reinforced concrete beams with Bakelite waste is generally lower compared to the control beam, except for the 8 % waste Bakelite beam which demonstrated a similar ultimate load capacity of 60 kN. Although managing Bakelite waste can be difficult because it can lead to the creation of microplastics in landfills over time, utilizing Bakelite waste in concrete can be a sustainable method of waste management. The innovative use of Bakelite waste as a partial replacement for coarse aggregate in concrete offers a sustainable solution to the problem of waste management and addresses the environmental concerns related to the disposal of non-biodegradable plastics. This research provides a practical solution for developing eco-friendly and cost-effective construction materials while promoting sustainable waste management practices

Health-seeking behaviour and its determinants of health of Under–5 Children living in urban slums of Chennai, India 2018

Background: Appropriate health-seeking behaviour could help in reducing child mortality and morbidity. Information on social factors of mortality and health-seeking behaviours of caregivers of under-5 children from slums of Indian cities is minimal in literature. Objectives: We estimated the prevalence of health-seeking behaviour for morbidity ofunder-5 children and its determinants in urban slums in Chennai city, India. Methods: A cross-sectional study was conducted using a mixed-method design among primary caregivers of under-5 children living in Chennai slums, India. Two-stage cluster sampling was adopted to select 40 slums. A total of 233 primary caregivers were interviewed. Nine focus group discussions and 18 in-depth interviews were conducted among the primary caregivers. Prevalence of inappropriate health-seeking behaviour was estimated, and determinants were identified by multivariate binary logistic regression analysis. Thematic analysis was done on qualitative data. Results: We interviewed 233 primary caregivers. The weighted prevalence of inappropriate health-seeking behaviour for under-five children in urban slums of Chennai was 53.9% (95% CI: 46.9 – 60.8). Primary caregivers educated above secondary school were more likely (AOR of 2.3, 95% CI: 1.3–4.1) to follow inappropriate health-seeking behaviour compared to those educated below. Similarly, caregivers who were unaware of young child feeding practices (AOR of 3.6, 95% CI: 1.9–6.5) and early care-seeking and health practices (AOR of 2.5, 95% CI: 1.3–4.9) were more likely to engage in inappropriate health-seeking behaviour compared to those who were aware and we found that illness symptoms influenced health-seeking behaviour and that early disease detection might prevent severe illness. Conclusion: Health-seeking behaviour was found to be suboptimal among under-5 children in Chennai's urban slums. We suggest policymakers improve interventions on early care-seeking of common childhood illnesses in the urban health programme

Quality of comprehensive assessment among severely ill TB patients referred after triaging in southern India

To reduce TB deaths, Tamil Nadu, a southern Indian state, implemented the first state-wide differentiated TB care strategy starting April 2022. Triage-positive severely ill patients are prioritised for comprehensive assessment and inpatient care. Routine program data during October–December 2022 revealed that documentation of total score after comprehensive assessment was available in only 39%, possibly indicating poor quality of comprehensive assessment. We confirmed this using operational research. The case record form to record comprehensive assessment was used only in 26% and among these, the completeness and correctness in filling out the form were sub-optimal. There is a clear need to enhance the quality of comprehensive assessments

­­Eleven tips for operational researchers working with health programmes: our experience based on implementing differentiated tuberculosis care in south India

Due to the workload and lack of a critical mass of trained operational researchers within their ranks, health systems and programmes may not be able to dedicate sufficient time to conducting operational research (OR). Hence, they may need the technical support of operational researchers from research/academic organisations. Additionally, there is a knowledge gap regarding implementing differentiated tuberculosis (TB) care in programme settings. In this ‘how we did it’ paper, we share our experience of implementing a differentiated TB care model along with an inbuilt OR component in Tamil Nadu, a southern state in India. This was a health system initiative through a collaboration of the State TB cell with the Indian Council of Medical Research institutes and the World Health Organisation country office in India. The learnings are in the form of eleven tips: four broad principles (OR on priority areas and make it a health system initiative, implement simple and holistic ideas, embed OR within routine programme settings, aim for long-term engagement), four related to strategic planning (big team of investigators, joint leadership, decentralised decision-making, working in advance) and three about implementation planning (conducting pilots, smart use of e-tools and operational research publications at frequent intervals). These may act as a guide for other Indian states, high TB burden countries that want to implement differentiated care, and for operational researchers in providing technical assistance for strengthening implementation and conducting OR in health systems and programmes (TB or other health programmes). Following these tips may increase the chances of i) an enriching engagement, ii) policy/practice change, and iii) sustainable implementation