Search PubMed⌕ Search

Biomedical subjects

K Anand

Publications and source records attributed to K Anand.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

Towards the elimination of iodine deficiency disorders in India.

Iodine deficiency disorders (IDD) are an important public health problem in India with an estimated 270 million people at risk of IDD. India has adopted the strategy of salt iodization for control of IDD and has the goal of "Universal iodization of salt by 1995 and elimination of IDD by 2000". There is a high degree of political commitment which need to continue if the goal is to be achieved. Currently the ban on ale of un-iodized salt is only applicable to salt on human consumption. There is a need for extending the ban to include salt for animal consumption as IDD affects livestock as well. India has the installed capacity to produce its requirement of 5 million tonnes iodised salt. Communication strategies have to be strengthened especially to educate people who have concerns about of iodine toxicity. The success to a large extent depends on the quality control and monitoring of iodine content of salt at all stages from production to consumption. NGO's and the community have to be encouraged to participate in this process. To sustain the elimination of IDD, a partnership of various stakeholders IDD elimination is essential.

Adolescent↗
PubMedDate not supplied

Cost of vitamin A and iron supplementation to "at risk" population.

This is a cost descriptive study which estimates the cost of providing iron and vitamin A supplementation through the primary health care system in India. The norms for the primary health care workers were taken as per national norms. The costs included the proportionate cost of the building, workers' salary and the cost of the supplements. The total cost of providing iron supplementation through the PHC was estimated at Rs. 43,800. The cost per beneficiary for adult folifer was Rs. 3.60, for paediatric folifer was Rs. 2.90 and for syrup folifer, it was Rs. 15.50. The overall cost of providing iron and folic acid supplements to the "at risk" population was estimated as Rs 4.40 per beneficiary per year. The cost of vitamin A supplementation to under three through the PHC system was estimated at Rs. 3.20 per beneficiary per year. Both iron as well as vitamin A supplementation through the PHC system appear to be low cost interventions.

Adolescent↗
PubMedDate not supplied

Risk factors for stillbirths in a secondary level hospital at Ballabgarh, Haryana: a case control study.

This study was conducted at a secondary level hospital at Ballabgarth, run by Centre for Community Medicine, All India Institute of Medical Sciences. The still birth rate during the study period 1987-1992 was 19.5 per 1,000 births. It showed a sudden decline during these six years probably reflecting the change in the admission policy of the hospital. A case control study of 72 still births and 144 controls was carried out to identify risk factors for still births. Maternal age, gravidity, previous history of still births or abortion were not found to be significantly associated with still births. Poor socio-economic status measured by parental literacy and occupation were significantly associated with still births. Lack of antenatal care [(OR 9.2 (2.5-37.9)], low birth weight (< 2500 gms) [OR-18.1 (4.4-74.5)], non-vertex presentation [(OR 41.2 (66-257.3)], maternal illiteracy [OR 2.75 (1.01-11.3)] were found to be the important predictors of still birth as identified by logistic regression analysis. The provision of good antenatal care and improvement of the socio-economic status, especially female literacy, will help in decreasing the still birth rate in the country.

Case-Control Studies↗
PubMedDate not supplied

Knowledge beliefs and practices regarding iodine deficiency disorders among the tribals in Car Nicobar.

It is estimated that 1,570 million people are at risk of iodine deficiency. Because of the wide spectrum of disorders that IDD includes, and lack of any obvious association between iodine deficiency and its health effects, IDD is not perceived as a major public health problem. For any disease to be effectively controlled, awareness at all levels from community to policy makers is necessary. This study was conducted to assess knowledge, beliefs and practices regarding iodine deficiency Disorders in Car Nicobar districts of Andaman and Nicobar Islands. The population is predominantly tribals involved in coconut plantations. All the village heads of the sixteen villages and parents of 10% of the school children examined for goiter were interviewed. Initial focus group discussions were conducted as no prior knowledge about local names for goitre or other related IDD information was available. The interview schedule was designed in English which was then translated into Hindi and Nicobarese and back translated into Hindi and English. A total of 114 persons were interviewed 60 males, 54 females. The local name for goiter was "Rulo" and 44% felt that it only affected females. No one had correct knowledge of the cause of goiter. About half of the respondents believed that these swellings caused problems. Sixty three (55.3%) of respondents believed that there was treatment, of which 33 said there was medical treatment, 18 respondents said traditional treatment by "LAM-EEN" and 12 felt that both therapies are required. Majority (85%) brought salt samples from the Government canteen. They did not now whether this salt was iodised. Salt was not washed before use and storage practice was satisfactory. The awareness about IDD needs reinforcement. At present the community is a passive participant in the I.D.D. Control Programme.

Adult↗
PubMedDate not supplied

Colocutaneous fistula: an unusual complication of percutaneous endoscopic gastrostomy.

We describe an unusual complication of percutaneous endoscopic gastrostomy, the formation of a colocutaneous fistula. The complication resulted from penetration of both the colon and stomach at the time of catheter placement. This problem went unrecognized for several months until the feeding catheter was removed, and its replacement could be advanced only as far as the colon. Complications of percutaneous endoscopic gastrostomy are reviewed, and the problem of gastrocolic fistula formation secondary to gastrostomy placement is discussed.

Abdominal Muscles↗
PubMedDate not supplied

Screening for chronic impairments using medical interns in rural Haryana, India.

BACKGROUND: With the increase in life expectancy, prevalence of impairments and disabilities are expected to increase in India. However, there have been very few studies to estimate the magnitude of the problem in rural India. This is essential, if appropriate rehabilitation services are to be planned in the country. METHODS: The study was done in the rural field practice area of the All India Institute of Medical Sciences at Ballabgarh, Haryana. The survey was conducted by successive batches of interns posted at Ballabgarh as a part of their compulsory rotating internship programme. The diagnostic criteria were based on history and simple clinical examination done at the domiciliary level. RESULTS: A total population of 25,509 in twelve villages were screened. The total impairment rate was 5.4% with no significant men/women difference. The prevalence of physical impairment was 4.7 per 1000 population. The prevalence of corneal opacity in children below 15 years of age was 4.7 per 1000. Prevalence of cataract was almost 35% in the population over 60 years of age and 15% in the population between 45 to 60 years. Auditory impairment was 19.6 per 1000 as ascertained by history. Three-fourths of this was conductive deafness and was found mainly in people above 60 years of age. CONCLUSION: Utilizing the rural field practice areas of medical colleges for collection of data on issues of national health importance would not only strengthen the health system in the country but also improve medical education. There is a need for a comprehensive preventive, promotive, curative and rehabilitative approach to disabilities in India.

Adolescent↗
PubMedDate not supplied

Typhoid fever vaccines.

Explore the source record for details and available documents.

Cost-Benefit Analysis↗
PubMedDate not supplied

Injection use in a village in north India.

BACKGROUND: Injections can transmit infections such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV), and precipitate poliomyelitis. Complications such as injection abscesses and nerve damage may also occur. It is estimated that 50% of the injections given in developing countries are unsafe. However, limited information is available from India. We planned a pilot study to assess the prevalence of injection use and the knowledge of the community and private medical practitioners (PMPs) about injection use. METHODS: One in every four houses in the village under study was selected by systematic random sampling. One adult (> 18 years) respondent in the family was asked questions about family members receiving injections in the past 6 months. Nine PMPs were interviewed about their knowledge and practices regarding injection use. RESULTS: In the past six months, 1280 family members in 285 houses received 1575 injections (2.46 injections per person per year). About 35% had received at least one injection in the past 6 months. Children below 5 years received 3.1 injections/child/year of which about 60% were preventive. On their last visit to a health facility, 55% of the subjects were given injections using disposable syringes. About 45% of the 285 respondents knew that diseases could be spread by improper use of injections. While 18% of the respondents said they would prefer injections, 54% preferred oral medications if both were equally effective. After being told the average cost of disposable needles and syringes, 92% of the respondents were willing to buy them. None of the 9 PMPs practising in the village were formally trained in modern medicine. On the day of observation, 18 of 58 patients (30%) seen by PMPs were given injections. Three injections were observed and though they were all given with disposable syringes, the technique of administration did not follow standard guidelines in any. Two PMPs did not know of any disease transmitted by injections. The syringes were usually thrown in a nearby drain or outside the village. Four PMPs said that patients themselves did not ask for injections. CONCLUSION: The use of injections in the study area was high. The PMPs were not only giving a high number of injections but the technique of administration was also wrong. The community was less likely to ask for injections on their own but was willing to buy disposable syringes and needles. The awareness about the risk of injections was low.

Adult↗
PubMedDate not supplied

Ethical issues in public health policy.

Ethics in public health policy is given the least importance and rarely discussed. Resolving ethical issues in public health is often an arduous task as these are complicated and require careful handling. Using four case studies, we discuss issues pertaining to pertussis and brain damage, water fluoridation and dental caries, infection with the human immunodeficiency virus and the right to marriage, and the debate surrounding universal salt iodization. The core issue in all these examples pertains to the relevance of ethics in public health policy.

Decision Making↗
PubMedDate not supplied

Passive malaria surveillance in a low endemic area of India: validation of a clinical case definition.

BACKGROUND: In India, 2.55 million cases of malaria were reported during 1997; roughly one-third were due to Plasmodium falciparum. Malaria cases are identified by passive and active surveillance and all patients with fever are treated with chloroquine (10 mg/kg body weight). Since all fevers are not malaria, this results in overtreatment and has a bearing in terms of the parasites developing resistance. We aimed to test the validity of a clinical algorithm for passive malaria surveillance by primary care doctors (fever with pallor or splenomegaly) in a low endemic, Plasmodium vivax-predominant area of Ballabgarh block in Faridabad District, Haryana. METHODS: Passive surveillance was carried out at the general and paediatric outpatient departments (OPDs) of Ballabgarh hospital. All persons with fever attending the OPD were examined for the presence of fever, pallor and splenomegaly by the treating doctor. A blood smear was prepared and examined in all these cases. RESULTS: A total of 3119 slides for malaria were made at Ballabgarh hospital but clinical details in the requisition form were available for only 2616 patients who form the subjects of this analysis. A total of 59 malaria cases (30 P. vivax cases and 29 P. falciparum) were diagnosed. The presence of fever with pallor or splenomegaly had a sensitivity of 28.8% (95% CI: 18.1-42.3); specificity of 88.6% (95% CI: 87.3-89.8), positive predictive value of 5.5% (95% CI: 3.3-8.8) and negative predictive value of 98.2% (95% CI: 97.5-98.7). CONCLUSION: The algorithm did not have sufficient sensitivity to detect malaria cases by passive surveillance.

Algorithms↗
PubMedDate not supplied

Consensus and conflicts in health sector reforms in India: a Delphi study.

BACKGROUND: Health sector reforms have generated much debate in India, especially in the context of economic liberalization. The World Bank intensified this debate in 1993 when it tried to redefine the role of the public and private sectors in healthcare. The Government of India has recently announced the National Health Policy. We are not aware of any formal exercise by which a consensus has been reached or conflicts in the issues related to health policy have been assessed. We present the results of such an exercise conducted in the format of a Delphi study. METHODS: Based on a review of the current literature, a 9-domain, 56-item questionnaire was prepared. This was sent to a panel of 132 respondents with diverse backgrounds, from the grassroots workers to policymakers by surface or electronic mall. They were asked to identify the three top priorities and to give their degree of agreement to the statements. The results of the first round were analysed and sent back to the respondents for reconsideration. Consensus was defined as the presence of > or = 75% of the respondents in agreement whereas conflict was said to be present if > 35% of the respondents were on either side of the divide. During the subsequent round, the respondents were also asked to give three suggestions on how to approach the previously identified top three priorities. RESULTS: Half (66) of the original list of panelists replied to the questionnaire. The three priorities identified and later ratified were: improving the quality of care of the primary healthcare system, improvements in medical education and setting up a disease surveillance system. Other areas of consensus identified were: setting up a formal channel of interaction with the private health sector, instituting cost recovery systems in the government sector, setting up a technology assessment commission and bringing accountability into the system. Conflicts were in continuation of subsidy in medical education, the role of and need for health insurance and the role of health professionals vis-a-vis Panchayati Raj institutions. CONCLUSION: We have demonstrated, on a small scale, the feasibility of assessing consensus on a wide range of issues. The approach is replicable, cost-effective and ensures that the scope of involvement is widened. Also, there is likely to be a greater feeling of self-involvement in the decisions made which would therefore meet with less resistance from the system during implementation.

Adult↗