Knowledge, Atitude and Perception regarding National Health Programmes among villagers of Chauras, Tehri-Garhwal, Uttarakhand

Background and Objective: Since India became independent, several measures have been undertaken by the national government to improve the health of the people. Prominent among these measures are the national health programmes. The main objective of these National Health programmes are protection and promotion of national and individual health. The main objective of this study was to assess the knowledge, attitude and perception regarding various national health programmes among the villagers. Methods: It is a descriptive and observational study. The study subjects comprised 273 respondents belonging to 15 to 64 years age group. The collection tool used was a pre designed questionnaire, which was pre-tested. Results: 60% of respondents were adults, about 16 percent were educated up to primary level and more than 40% belonged to scheduled castes. Nearly 20% were aware about National AIDS Control Programme and 6.59% had clear knowledge about HIV/AIDS. Only 4.02% knew about the national vector borne disease control programme and 24% women clearly knew about exclusive breast feeding. Peripheral health workers were the most common source of information regarding these programmes. 64% of respondents opined that these national health programmes are good. Conclusion: Low level of knowledge was observed among the respondents regarding National Health Programmes

Energy-efficient traffic engineering

The energy consumption in telecommunication networks is expected to grow considerably, especially in core networks. In this chapter, optimization of energy consumption is approached from two directions. In a first study, multilayer traffic engineering (MLTE) is used to assign energy-efficient paths and logical topology to IP traffic. The relation with traditional capacity optimization is explained, and the MLTE strategy is applied for daily traffic variations. A second study considers the core network below the IP layer, giving a detailed power consumption model. Optical bypass is evaluated as a technique to achieve considerable power savings over per-hop opticalelectronicoptical regeneration. Document type: Part of book or chapter of boo

Pulmonary effects of passive smoking: the Indian experience

There are only a few studies done on pulmonary effects of passive smoking from India, which are summarized in this paper. Several vernacular tobacco products are used in India, bidis (beedis) being the commonest form of these. Bidis contain a higher concentration of nicotine and other tobacco alkaloids compared to the standard cigarettes (e.g., the sum of total nicotine and minor tobacco alkaloids was 37.5 mg in bidi compared to 14–16 mg in Indian or American cigarettes in one study). A large study performed on 9090 adolescent school children demonstrated environmental tobacco smoke (ETS) exposure to be associated with an increased risk of asthma. The odds ratio for being asthmatic in ETS-exposed as compared to ETS-unexposed children was 1.78 (95% CI: 1.33–2.31). Nearly one third of the children in this study reported non-specific respiratory symptoms and the ETS exposure was found to be positively associated with the prevalence of each symptom. Passive smoking was also shown to increase morbidity and to worsen the control of asthma among adults. Another study demonstrated exposure to ETS was a significant trigger for acute exacerbation of asthma. Increased bronchial hyper-responsiveness was also demonstrated among the healthy nonsmoking adult women exposed to ETS. Passive smoking leads to subtle changes in airflow mechanics. In a study among 50 healthy nonsmoking women passively exposed to tobacco smoke and matched for age with 50 unexposed women, forced expiratory volume in first second (FEV1) and peak expiratory flow (PEF) were marginally lower among the passive smokers (mean difference 0.13 L and 0.20 L-1, respectively), but maximal mid expiratory flow (FEF25–75%), airway resistance (Raw) and specific conductance (sGaw) were significantly impaired. An association between passive smoking and lung cancer has also been described. In a study conducted in association with the International Agency for Research on Cancer, the exposure to ETS during childhood was strongly associated with an enhanced incidence of lung cancer (OR = 3.9, 95% CI 1.9–8.2). In conclusions several adverse pulmonary effects of passive smoking, similar to those described from the western and developed countries, have been described from India

SELF-MICROEMULSIFYING DRUG DELIVERY SYSTEM

ABSTRACTOral route is the most convenient route of drug administration in many diseases and till today it is the first way investigated in the development ofnew dosage forms. The major problem in oral drug formulations is low and erratic bioavailability, which mainly results from poor aqueous solubility,thereby pretense problems in their formulation. More than 40% of potential drug products suffer from poor water solubility. For the therapeuticdelivery of lipophilic active moieties (biopharmaceutical classification system Class II drugs), lipid-based formulations are inviting increasingattention. Currently, a number of technologies are available to deal with the poor solubility, dissolution rate, and bioavailability of insoluble drugs.One of the promising techniques is self-microemulsifying drug delivery systems (SMEDDS). SMEDDS have gained exposure for their ability to increasesolubility and bioavailability of poorly soluble drugs. SMEDDS, which are isotropic mixtures of oils, surfactants, solvents, and co-solvents/surfactantscan be used for the design of formulations to improve the oral absorption of highly lipophilic drug compounds. Conventional SMEDDS are mostlyprepared in a liquid form, which can have some disadvantages. SMEDDS can be orally administered in soft or hard gelatin capsules and form finerelatively stable oil-in-water emulsions. Solid-SMEDDS are prepared by solidification of liquid/semisolid self-micron emulsifying ingredients intopowders, have gained popularity. This article gives a complete overview of SMEDDS, but special attention has been paid to formulation, design,evaluation, and little emphasis on application of SMEDDS.Keywords: Self-microemulsifying drug delivery system, Surfactant, Oil, Co-surfactant, Bioavailability, Lipophilic, Biopharmaceutical classificationsystem Class II drugs

Fetus-in-fetu: A Rare Congenital Anomaly

Two cases of fetus-in-fetu, on which we performed surgery in 2003 and 2006, are being reported. Both the cases presented with a lump in the abdomen. Radiology confirmed the diagnosis. The lumps were found in the retroperitoneum and successfully excised. Because of the rarity of the condition, these two cases are being reported with relevant salient features and are discussed in the light of available literature. Key words: Abdominal lump, axial skeleton, fetus-in-fetu, retroperitoneal, teratom

Is Nuchal Cord a Perfect Scapegoat: A Retrospective Analysis from Northwest India?

Background: Entanglement of the umbilical cord around the fetal neck (nuchal cord) is quite a common fi nding at delivery. It is often assumed that nuchal cord causes cord compression and thus low birth weight and intrapartum complications. Aim: The aim of this article is to study the eff ect of nuchal cord on the mode of delivery, complications and fetal outcome. Materials and Methods: A retrospective study was carried out on 386 deliveries, 60 of them with nuchal cord, during 1 year from November 2009 through October 2010. Their mode of delivery, complications and fetal outcome were studied and a comparison was established between nuchal cord group and the rest of the deliveries. Nuchal cord group was subdivided into loose nuchal cord (cord could easily be uncoiled before complete delivery of the baby) group and tight nuchal cord (cord was needed to be clamped and cut before delivery of the baby) group. Furthermore, the mode of delivery and fetal outcome were compared between these subgroups. Statistical analyses were performed using SPSS statistical soft ware version 12.0 (Chicago Illinios, USA). The results were expressed as percentages. Test for significance was done using Chi-square, and a P<0.05 was considered as significant.Results: The nuchal cord group did not have any signifi cant diff erence in the mode of delivery or fetal outcome compared with the control group. However, the subgroup having tight cord around the neck had significantly higher proportion of low Apgar scores and meconium staining at birth.Conclusions: Nuchal cord does not increase the chances of cesarean delivery. However, tight cord around the neck may result in low Apgar scores and increased incidence of fetal distress leading to cesarean section.  Keywords: Apgar score, cesarean delivery, meconium staining, north west India, nuchal cord, perinatal outcom

Association Between Use of Tobacco and Age on Graying of Hair

Aims and Objectives: To determine the association between smoking, chewing tobacco (gutka), and age of individual on graying of hair. Materials and Methods: The present study was conducted on 120 patients attending the Outpatient Department of the DJ College of Dental Sciences and Research, Modinagar, UP. The individuals were classified into four groups (group I, II, III, IV) on the basis of the form of tobacco use (smoking or chewing). The Pearson correlation coefficient was utilized to find the correlation between the mean percentage of individuals with gray hair, risk multiplication factor (RMF), and age of the individual. Results: Mean percentage of individual with gray hair and RMF (r = 0.6487) are found to be positively associated. A significant and positive correlation was observed between the age of the individual and the frequency of individuals with gray hair. Conclusion: This study suggests that there is a significant association between tobacco use and aging on graying of hair.Keywords: Graying of hair, risk multiplication factor, smokin

ELICITATION OF TRIGONELLINE, A HYPOGLYCEMIC AGENT IN FENUGREEK SPROUTS BY CALCIUM AND NITRIC OXIDE PRIMING

Objective: This work was performed to evaluate the effect of priming with exogenous sources of calcium ion and nitric oxide on the antidiabeticactivity and the alkaloid contents of fenugreek sprouts along with isolation and identification of trigonelline, a bioactive alkaloid responsible for hypoglycemic property of fenugreek.Methods: The fenugreek seeds were pre-treated with calcium chloride (CC), lanthanum chloride (LC) a calcium channel blocker; ethylene glycol-bis (2-aminoethylether) -N, N, N´, N tetra acetic acid (EG) a calcium chelator; sodium nitroprusside (SNP) and 2-(4-carboxyphenyl) -4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide (CP) a nitric oxide scavenger and germinated for 72 hrs. The sprout extracts were evaluated for their in vitro antidiabetic potential by α-amylase and α-glucosidase inhibition along with their trigonelline content. Trigonelline was isolated from fenugreek sprouts and identified by Infrared analysis and nuclear magnetic resonance (NMR) spectroscopy.Results: The results revealed that sprouts pre-treated with CC and SNP exhibited enhanced antidiabetic potential as well as alkaloid content overcontrol; on the other hand, their action was reversed by their antagonists, EG, LC, and CP. The sprouts pre-treated with 2mM CC showed the best elicitation of alkaloid content and antidiabetic activity followed by SNP-20 mM.Conclusions: The study suggests probable involvement of the signaling molecules, calcium ion, and nitric oxide in pathways associated withbiosynthesis of bioactive compounds responsible for hypoglycemic activity of fenugreek sprouts one of which being trigonelline. Â

Operating Manifold Services in Hospitals: A costly affair?

Manifold services form an important cost centre in hospitals. Most public sector hospitals do not have standard cost accounting system and therefore budget allocation is often difficult for support services such as the manifold. The study was conducted in a 1045 bedded tertiary care hospital in New Delhi, India with the objective of identifying the cost incurred in delivery of manifold services.This traditional costing exercise was conducted from 01 July to 30 Sept 2010 and included classification of costs, identification of the cost centres in the hospital, cost allocation and apportioning. Direct and indirect costs as well as capital and operational costs were calculated. The process of manifold services from delivery to the operational aspects was studied. Tender documents and supply orders were perused to arrive at expenditure on manifold gas pipeline system, equipment & accessories. Total annual cost of manifold services at the hospital was calculated to be $333,676 and per day cost was calculated to be$ 941 .Annual cost per manifold terminal unit was $207.3. The daily cost of manifold system was calculated to be$ 0.56. The annual and daily cost per bed was deduced to be $320 and$ 0.87 respectively.While manifold is a vital support service, the fact remains that it is cost intensive and underutilized and often poorly planned in terms of cost effectiveness. The focus on technology in manifold services needs to be sustained