A Study on Social Work in Home for the Aged as Perceived by Social Work Student in Tiruchirappalli District

Old age homes are meant for senior citizens who are unable to stay with their families or are destitute. Old age homes have special medical facilities for senior citizens such as mobile health care, ambulances, nurses and provision of well-balanced meals. The last century has witnessed a rapid increase in the population of the elderly people in the developed and industrialized countries. This situation could be attributed to a combination of factors such as increase in age, longevity and decreased death rates due to advancement in the field of medicine, improvement of life expectancy at birth, and enhancement in the average span of life. India ranks 4th in terms of absolute size of the elderly population. The country is not adequately equipped to look after their special health needs and the changing traditional value system. In the above context, a study was conducted to understand the feeling of the elderly residing in the old age homes and within the family setup in Tiruchirappalli District. The present paper attempts to portrait various problems experienced by the old age people. The paper also explains the social work intervention of Case Work, Group Work and Community Organization Programme in case of old age people. Results of the study revealed that most of the elderly people felt that the attitude of the younger generation is unsatisfactory towards them in terms of getting respect, love and affection from the family members instead they were considered as a burden for others. Women living in the families had a positive attitude towards the old age. There was a fall in the overall efficiency, sociability, degree of involvement in work and hobbies. On the other hand, better social relations were maintained by the family because they had regular interaction, expressions of feelings and support as a family. The present paper aims to highlight the problems of the aged as perceived by Social Work Student. Keywords: Old Age Home. Family. Life Expectancy. Methods of Social Work

Arthroscopic assisted fixation of central depressed lateral tibial plateau fracture: case report

Arthroscopic assisted fixation has become the gold standard for managing Schatzker III tibial plateau fractures. There are different techniques available to reduce and fix the central depression. We present one such case of a 41 years old female who had good outcome following arthroscopic assisted fixation using anterior cruciate ligament guide, dilators and calcium hydroxyapatite bone substitute

A numerical study on the influence of tunnel excavation on pile foundation

Tunnel construction in cities faces many geotechnical challenges, and the effect on pile foundation is possibly one of the most complex ones. Most tall buildings in big cities mostly have pile foundations, and any tunneling nearby might significantly influence those existing foundations. In the present study, a 3-dimensional Finite Element (FE) analysis has been carried out to investigate tunneling effects on pile foundations. The investigation is done for a single pile with multiple stages of tunnel excavation where the pile foundations are assumed to reach below the base of the excavation of tunneling. A tentative rate of excavation was also included in this investigation and found that a faster rate of excavation results in better performance of foundations affected by tunneling. The study also extended to see the effect of tunneling on pile groups. Attempts were made to compare the results with some of the previously published literature

Diarrhea, CD4 counts and enteric infections in a hospital - based cohort of HIV-infected patients around Varanasi, India

Background: As most of the studies in HIV patients with diarrhea were cross sectional, focusing on the etiological agents, we are reporting data on the rate of diarrhea, associations between diarrhea and CD4 counts and variation in frequency of identifying a pathogen with consistency of diarrhea and duration in a prospective hospital based study. Methods: Stool specimens were obtained between Jan 2001 and April 2003 from HIV infected adults with diarrhea presenting to Infectious Disease clinic, Banaras Hindu University, Varanasi. In all patients with diarrhea, specimens were examined by microscopy and cultures to identify pathogens. Results: During the study, 630 person years of observations with diarrhea were analyzed. 140 stool samples were collected representing 43% of episodes of reported diarrhea. Positivity of finding a pathogen from watery stools and formed stools were 40%&24% respectively (p < 0.01) probably due to associated inflammation is more in watery diarrhea. Patients having chronic diarrhea are 2.25 (95%CI 1.52-2.81) times at more risk of developing other opportunistic infections compared to those who don't have. However this is not true with the acute diarrhea where risk of harboring the opportunistic infections remain same. Conclusion: Diarrhea was most strongly associated with low CD4 counts. Over two-thirds of diarrheal episodes were undiagnosed, suggesting that unidentified agents or primary HIV enteropathy are important causes of diarrhea in this population. There is a strong negative association between duration of diarrhea and CD4 levels

Cross-sectional and longitudinal analysis of cancer vaccination trials registered on the US Clinical Trials Database demonstrates paucity of immunological trial endpoints and decline in registration since 2008

INTRODUCTION: Cancer vaccination has been researched as a means of treating and preventing cancer, but successful translational efforts yielding clinical therapeutics have been limited. Numerous reasons have been offered in explanation, pertaining both to the vaccine formulation, and the clinical trial methodology used. This study aims to characterize the tumor vaccine clinical trial landscape quantitatively, and explore the possible validity of the offered explanations including the translational obstacles posed by the current common endpoints. METHODS: We performed a detailed cross-sectional and longitudinal analysis of tumor vaccine trials (n=955) registered in the US Clinical Trials database. RESULTS: The number of tumor vaccine trials initiated per annum has declined 30% since a peak in 2008. In terms of vaccine formulation, 25% of trials use tumor cell/lysate preparations; whereas, 73% of trials vaccinate subjects against defined protein/peptide antigens. Also, 68% of trials do not use vectors for antigen delivery. Both these characteristics of tumor vaccines have remained unchanged since 1996. The top five types of cancer studied are: melanoma (22.6%); cervical cancer (13.0%); breast cancer (11.3%); lung cancer (9.5%); and prostate cancer (9.4%). In addition, 86% of the trials are performed where there is established disease rather than prophylactically, of which 67% are performed exclusively in the adjuvant setting. Also, 42% of Phase II trials do not measure any survival-related endpoint, and only 23% of Phase III trials assess the immune response to vaccination. CONCLUSION: The clinical trial effort in tumor vaccination is declining, necessitating a greater urgency in identifying and removing the obstacles to clinical translation. These obstacles may include: 1) vaccination against a small range of antigens; 2) naked delivery of antigen; 3) investigation of less immunogenic cancer types; and 4) investigation in the setting of established disease. In addition, the prevalence of late phase failure may be due to inadequate assessment of survival-related endpoints in Phase II trials. The clinical trial development of tumor vaccines should include mechanism-based translational endpoints, as well as the discovery of immune biomarkers with which to stratify, monitor, and prognosticate patients

Effect of Alectra Parasitica Var. Chirakutensis on Aspirin Induced Ulceration in Rats

ABSTRACT The effect of 50 % ethanolic extract of Alectra parasitica var. Chirakutensis was assessed in different acute gastric ulcer models in rats. Alectra parasitica administered orally at dose levels of 50 -200 mg/kg, twice daily for 3 days showed dose dependent ulcer protective effect 48.89 -82.22% protection on aspirin -induced acute ulcers. Besides, Alectra parasitica reduced the ulcer index with significant (P < 0.01 and <0.001) protection of lipid peroxidation and superoxide dismutase and increased in catalase activity, respectively. Preliminary phytochemical screening of the Alectra parasitica gave the positive test for steroids, alkaloids, terpenoids, saponins and tannins. The results indicate that Alectra parasitica possesses antiulcer activity

Cost-Effectiveness Analysis of Combination Therapies for Visceral Leishmaniasis in the Indian Subcontinent

Visceral leishmaniasis (VL) is a serious health problem in the Indian subcontinent affecting the rural poor. It has a significant economic impact on concerned households. The development of drug resistance is a major problem and threatens control efforts under the VL elimination initiative. With an unprecedented choice of antileishmanial drugs (but no newer compound in clinical development), policies that protect these drugs against the emergence of resistance are required. A possible strategy that has been successfully used for malaria and tuberculosis is the use of combination therapies. This study is the first comprehensive assessment of the cost-effectiveness of all possible mono- and combination therapies for the treatment of visceral leishmaniasis in the Indian subcontinent. The analysis was done from the societal perspective, including both health provider and household costs. The present work shows that combination treatments are a cost-effective alternative to current monotherapy for VL. Given their expected impact on emergence of drug resistance, the use of combination therapy should be considered in the context of the VL elimination programme in the Indian subcontinent

Drug Susceptibility in Leishmania Isolates Following Miltefosine Treatment in Cases of Visceral Leishmaniasis and Post Kala-Azar Dermal Leishmaniasis

Resistance to antimonials has emerged as a major hurdle to the treatment and control of VL and led to the introduction of Miltefosine as first line treatment in the Indian subcontinent. MIL is an oral drug with a long half-life, and it is feared that resistance may emerge rapidly, threatening control efforts under the VL elimination program. There is an urgent need for monitoring treatment efficacy and emergence of drug resistance in the field. In a set of VL/PKDL cases recruited for MIL treatment, we observed comparable drug susceptibility in pre- and post-treatment isolates from cured VL patients while MIL susceptibility was significantly reduced in isolates from VL relapse and PKDL cases. The PKDL isolates showed higher tolerance to MIL as compared to VL isolates. Both VL and PKDL isolates were uniformly susceptible to PMM. MIL transporter genes LdMT/LdRos3 were previously reported as potential resistance markers in strains in which MIL resistance was experimentally induced. The point mutations and the down-regulated expression of these transporters observed in vitro could, however, not be verified in natural populations of parasites. LdMT/LdRos3 genes therefore, do not appear to be suitable markers so far for monitoring drug susceptibility in clinical leishmanial isolates