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PubMedDate not supplied

Inter-state variations in integration of leprosy services into general health system in low/ moderately endemic states of India.

The objective of the study was to analyse inter-state variations in integration of leprosy services into the general health system, covering broad categories of structure integration, training of health functionaries, availability of MDT services and record maintenance, in 24 low/moderately endemic states. Multi-stage random sampling technique was used to select 9 states, 86 health facilities (including district hospitals, community health centres, primary health centres) and 108 sub-centres. Information from each level was collected on a pre-tested form by officers of three leprosy institutions of the Government of India. The results showed wide inter-state variations on each aspect. Redeployment of vertical staff was complete (100%) in Tamil Nadu and Tripura. Assam reported a higher level of training (97%) of medical officers in leprosy. Training of health supervisors and multipurpose workers was better than that of medical officers in most of the states. Tripura reported negligible training of all the health functionaries because of specific local problems. In Assam, Maharashtra and Sikkim, all the urban and rural health facilities were providing MDT. Three months' stock of all types of MDT blister packs was available only in one health facility in Andhra Pradesh and in Goa. Assam and Haryana had lower availability of MDT stocks. In Assam and Maharashtra, medical officers in all health facilities were diagnosing and treating leprosy cases, as compared with Himachal Pradesh where the value was 30%. Involvement of sub-centres in MDT delivery was more at 92% and 100% in Tamil Nadu and Maharashtra respectively in comparison to none in Himachal Pradesh and Tripura. Use of the Simplified Information System (SIS) 2002 guidelines and formats was universal. However, lower involvement of GHS staff in recording and reporting was noted in Assam (0%), Andhra Pradesh (10% and 30%). The study emphasized the need for further tailor-made follow-up studies to suit local problems.

Delivery of Health Care, Integrated↗
PubMed1989

Retinal organisation in a hill-stream cyprinid, Crossocheilus latius latius Hamilton.

The retinal organisation of a cyprinid fish, Crossocheilus latius latius Hamilton, which inhabits the sub-Himalayan torrents of Sikkim, India, has been studied by light microscopy. The fish are small and cylindrical having relatively large eyes with a large, oval pupil. They are adapted to the low-light level of the hill-torrents, which is caused by the heavily silted monsoon water. The retina possesses numerous rods and bulky cones, the latter containing multiple oil droplets, and located mostly sclerally and some both sclerally and vitreally. There are three rows of large horizontal cells and a few bipolar and sparsely distributed ganglion cells. Retinomotor response, as evidenced by the scleral migrations of photoreceptors and pigment epithelium during dark-adaptation, is prominent in the species. The bulky cones with their prominent, multiple oil droplets have been suggested as the devices which help the fish to negotiate in the hill-stream's turbid environment.

Animals↗
PubMed1995

Microflora of murcha: an amylolytic fermentation starter.

Murcha is a traditional starter, used commonly in Darjeeling hills and Sikkim in India to ferment a variety of starchy substrates in order to produce sweet-sour alcoholic beverages, called jnards. Murcha cakes are mildly acidic (pH 5.2) and contain 13% w/w moisture and 0.7% w/w ash (dry weight basis). A total of 194 bacterial, 190 yeast and 80 mould strains were isolated from 30 samples of murcha. The counts (cfu/g fresh weight) of micro-organisms in the samples were 2.0 x 10(7) to 4.2 x 10(8) for Pediococcus pentosaceus, 4.0 x 10(7) to 6.8 x 10(8) for Saccharomycopsis fibuligera, 2.0 x 10(6) to 7.2 x 10(7) for Pichia anomala, 1.0 x 10(6) to 4.1 x 10(7) for Mucor circinelloides and < 10 to 1.0 x 10(6) for Rhizopus chinensis. While all the species were prevalent in 100% of the samples, R. chinensis was detected in only 50% of them. Both the moulds but one yeast species, S. fibuligera had amylolytic activity.

Amylases↗
PubMedDate not supplied

Health and human resource mobilization: an assessment of staffing pattern in NLEP at operational level.

In this paper the staffing pattern, training and infrastructural facilities of the National Leprosy Eradication Programme (NLEP) at operational level as well as the attendant problems in mobilising human resources are discussed. The study shows that the major portion of the work of the NLEP is being shared by the PMWs (72%), followed by NMS (14%) and Medical Officers (5%). The population served by the PMW in all the high and moderate endemic regions is more than the prescribed limit except in Nagaland and Sikkim. In the same areas, the Medical Officer serves a population more than the norm in Andhra Pradesh, West Bengal, Maharashtra, Karnataka and Bihar. Regarding case load, in no state the M.O. serves more than 2500 cases except in Bihar and Kerala, in moderate endemic and low endemic regions respectively. The PMW in Haryana and Punjab states attends more than 250 cases. In NLEP every one out of four sanctioned posts is vacant. There is also an urgent need to rationalize the training programme so that there is optimal utilization of the training centres.

Health Services↗
PubMed1997

[Dr Alexander M. Kellas and the first Mount Everest expedition].

In 1921 the government of Tibet gave permission for a British party to attempt Mount Everest from the northern Tibetan side. Little was known about the physiological and medical problems associated with ascents to extreme altitudes. The person who knew most about these topics was Dr. Alexander Kellas, lecturer in medical chemistry at the Middlesex Hospital Medical School. He had made a number of expeditions to the Sikkim Himal and the Tibetan border before the first world war, and had become increasingly interested in the problems caused by altitude. He was invited to join the Everest expedition but died on the approach march at Kampa Dzong on the Tibetan plateau, within sight of the mountain. Before he went on the expedition Kellas wrote an article entitled A consideration of the possibility of ascending Mt. Everest. This paper was never published, but the manuscript exists in the archives of the Royal Geographical Society and the Alpine Club in London. As Kellas saw it, the main issue was whether sufficient adaptation could occur to allow a climber to ascend from a camp at about 7,700 m to the summit (8,848 m) in one day without supplementary oxygen. His conclusion was that this was possible and, in fact, the first such ascent by Habeler and Messner in 1978 started from a camp at 7,900 m. Kellas calculated the pressure on the summit to be 251 mmHg, a more accurate figure than estimates based on the "Standard Atmosphere" Kellas estimated maximum oxygen uptake at the summit to be 970 ml/min, and the current value is thought to be about 1,070 ml/min. His estimates of the climbing rate near the summit closely parallels the rate of Habeler and Messner. Kellas had a talent for asking the right questions. He applied his considerable knowledge of physiology to the topic of high altitude, and his suggestions and recommendations were of consistently high quality. He deserves to be better known, both for his geographical surveys and for his pioneer work on high altitude medicine and acclimatisation. The 1921 expedition, after many failed attempts, discovered a possible route to the top of Mount Everest, which was used on all the summit attempts between the two world wars. The route went from Kharta, over the pass Lhakpa La, across East Rongbuk glacier and up via the north col.

Expeditions↗
PubMed2005

Religious beliefs about causes and treatment of epilepsy.

BACKGROUND: It has been acknowledged that religious and complementary therapies are commonly used among South Asian communities in the UK. However, little is known about their religious beliefs in relation to epilepsy and the type of South Asian therapies that they use to treat the condition. AIM: To explore the influences of spiritual and religious beliefs on explanation of the cause of epilepsy, and the choice of treatment in people of South Asian origin who have epilepsy. DESIGN OF STUDY: Qualitative study using interviews with patients, carers, health professionals, and focus groups of people from minority ethnic communities. SETTING: Bradford and Leeds. METHOD: Semi-structured individual interviews with 20 Muslims, six Sikhs, and four Hindus with epilepsy; 16 nominated carers (family members, friends); 10 health professionals (specialist GPs, neurologists, specialists nurses, social workers, community GPs); and two focus groups with a total of 16 South Asians without epilepsy. RESULTS: It was found that over half of responders attributed their illness to fate and the will of God, or as punishment for sins of a past life. Some patients had experienced prejudice from people who believed that their epilepsy was contagious. A strong network of traditional healers was found, providing a parallel system of health care in the UK and on the Indian subcontinent. People turned to religiospiritual treatments in desperation for a cure, often under the influence of their families after the perceived failure of Western medicine. Such treatments were viewed as complementary rather than as an alternative to Western medication. Younger people in particular expressed considerable scepticism about the effectiveness of these traditional South Asian treatments. CONCLUSIONS: In this study's South Asian sample, patients commonly turned to traditional healers in search of better health. Health professionals should be aware of the belief systems of these patients and understand the types of treatments in common use. Although these treatments might potentially compete with Western health care, they are used as an adjunct rather than a substitute. Patients have a 'healthy' scepticism about the effectiveness of such treatments, and adherence to medical therapy does not appear to be affected.

Adolescent↗
PubMed1995

An epidemiological study of coronary heart disease in different ethnic groups in Delhi urban population.

A community based epidemiologival survey of coronary heart disease (CHD) was carried out on a random urban sample of 13,560 adults of different ethnic groups in Delhi. CHD was diagnosed either on the basis of clinical history, supported by documentary evidence of treatment in hospital/home or on the ECG evidence in accordance with Minnesota Code. The prevalence rate of CHD on clinical basis per 1000 adults was the highest in Sikhs (47.3), lowest in Muslims (22.8) and identical in Hindus (31.8) and Christians (31.2). The prevalence rate/1000 of silent CHD on the basis of ECG was high in Muslims (89.5) and Sikhs (87.3), low in Christians (25.0) and intermediate in Hindus (60.0). The Sikhs showed the highest prevalence rate of myocardial infarct (MI) (15.5) and angina (AP) (31.8) compared to other communities. The prevalence rate of CHD on clinical basis was higher in males than females in all communities. The prevalence of silent CHD was higher in females in Hindus and Sikhs but in Muslims it was higher in men (94.8) than in women (85.2). The wide variations in prevalence rates of CHD in different ethnic groups cannot be explained satisfactorily on the basis of conventional risk factors and support the multifactorial etiological character of CHD.

Adult↗