The Impact Of Mental Health Education On The Knowledge And Attitude Of The Peripheral Health Workers Of Dang.

Background & Objective: Mental health needs of a society are ideally met by integration in primary care. Under the District Mental Health programme, Surat is the nodal centre for Dang, a tribal region. In order to make medical care available to the patients in need, it was vital to train the peripheral health workers of the region. The aim was to provide mental health education to the peripheral health workers of Dang and assess its impact on their knowledge and attitude regarding mental health issues. Methodology: 150 peripheral health workers were posted in the Department of Psychiatry in batches of 20-30 each for a 7-day, extensive, in-house training. The improvement in knowledge and attitude was assessed by a pre-post semi-structured questionnaire and structured feedback. Results: The training resulted in a significant improvement in scores related to clarification of myths. The knowledge and attitude related to mental health issues improved significantly and the participants reported that they were sensitized by the training and would identify and refer patients to the visiting psychiatrist. Conclusion: The training in mental health could bring about improvement in the knowledge and attitude of the peripheral health workers. However, to what extent does this change reflect in actual practice, needs to be ascertained.

Investigation into the possible mechanisms involved in altered digoxin levels in diabetic patients.

The present study was undertaken to investigate the possible factors which may contribute to the altered digoxin levels in diabetic patients. The digoxin levels were found to be significantly higher in diabetics (1.74 +/- 0.09 ng/ml) as compared to non-diabetics (0.76 +/- 0.07 ng /ml). There was a positive correlation between digoxin levels and glycosylated haemoglobin levels. All diabetic patients had serum creatinine, urea and potassium levels within normal limits. However, serum TSH levels were found to be significantly higher in diabetics as compared to controls. Serum tri-iodo-1-thyronine (T3) levels were found to be lower in diabetics as compared to non-diabetics. Our data suggests that diabetes-mellitus causes alteration of digoxin levels. One of the causes of this increase in digoxin levels may be a tendency towards mild hypothyroidism associated with diabetes mellitus.

Involvement of K+ channels in the relaxant responses to various agonists in estrogen primed rat uterus.

The present investigation was undertaken to study the effects of K+ channel openers in the relaxant responses to various agonists in estrogen primed rat uterus. Adrenaline and isoprenaline produced a dose-dependent relaxation in the estrogen primed rat uterus. The relaxant responses were found to be significantly potentiated when the preparations were exposed to PSS devoid of calcium. The responses to isoprenaline were found to be greater in the preparations depolarized with 40 mM KCl instead of 80 mM KCl. KCl failed to produce any contractile effect in the presence of D-600. Further, the addition of D-600 completely relaxed the KCl depolarized rat uterus. Pinacidil and cromakalim failed to relax 80 mM KCl depolarized rat uterus. However, they produced dose-dependent relaxation in the preparations depolarized with 40 mM KCl. The relaxant responses to pinacidil and cromakalim were competitively blocked by procaine. However, they were not altered by either propranolol or cimetidine. The relaxant responses to isoprenaline and histamine were found to be potentiated by pinacidil and cromakalim. These results indicate that in rat uterus in addition to adenylate cyclase c-AMP, potassium channels are also involved in the relaxant responses to isoprenaline and histamine.

Antibody response of children immunized with poliovaccines: an evaluation using two strains of poliovirus type 1.

Neutralizing antibody response of children immunized with either OPV (3 doses), or IPV (2 doses) was evaluated against poliovirus type 1 Sabin vaccine strain and a local neurovirulent isolate. Both vaccines elicited significantly better antibody response against the vaccine strain than against the neurovirulent isolate. Moreover, approximately 35 per cent of sera contained very low levels of antibody against the virulent virus in spite of good antibody titre against the vaccine strain. The observed difference in antibody response to the wild and the vaccine strains was significant. The differential immune response could be one of the reasons of paralytic disease observed even after administration of OPV (3), in some children if infecting virus dose is high, as in case of urban slums in endemic areas.

Intratypic characterization of poliovirus type 1 isolates.

Intratypic serodifferentiation of 607 strains of poliovirus type 1 isolated from diverse epidemiological groups, was carried out using strain-specific antisera and monoclonal antibodies. The isolates were from patients of paralytic poliomyelitis from Marathwada (an epidemic area) and Bombay (endemic area) and from healthy children from Emmaneshwaram (vaccinated area). From Marathwada where mass scale vaccination with oral poliovirus vaccine (OPV) was performed to contain the spread of the epidemic, non-vaccine-like and vaccine-like virus strains were isolated. Only non-vaccine-like virus strains were detected among the Bombay isolates. In Emmaneshwaram mass-scale vaccination performed in 1986 had earlier led to the replacement of the wild poliovirus with the vaccine strains. However, even though systematic OPV immunization reached 93 per cent coverage in 1987 and 1988, majority of isolates from Emmaneshwaram were found to be non-vaccine-like. Results showed that routine immunization of children with OPV was not sufficient to displace the wild virus. A small number of antigenic variants were detected. The frequency of such variants was more when mass-scale vaccinations were performed after paralytic poliomyelitis outbreaks. Using a panel of monoclonal antibodies epitope mapping of these variants was performed.

Efficacy of three doses of oral polio immunization beginning within the first four days of life.

A study was carried out to test the efficacy of oral polio immunization commencing in the newborn period. In Group A, 47 term newborn infants were given trivalent oral polio vaccine (TOPV) within the first four days, at one month and at two months. In Group B, 21 infants were given TOPV at 3, 4 and 5 months. The seroconversion rates for types 1, 2 and 3 were 87.2, 95.7 and 72.3%, respectively in Group A and 85.7, 95.2 and 66.7%, respectively in Group B after 3 doses of TOPV, the differences being insignificant. Oral polio immunization beginning in the newborn period was as effective as when commenced at 3 months of age. Before immunization, the number of babies with protective titers against polioviruses were significantly more in Group A as compared to Group B. Thus, the later onset of immunization schedule leaves more children susceptible to poliomyelitis during the first 3 months of life.

Effect of mepyramine on the histaminase release induced by heparin injection and anaphylaxis in guinea pigs.

Injection of heparin as well as antigenic challenge in sensitized guinea pigs are known to produce a release of histaminase into the plasma. In the present study, tissue histaminase estimation was done by Spencer's method (17) and plasma estimation by Kapellar Adler's (7) method. Mepyramine pretreatment considerably decreased the histaminase release by both heparin and anaphylaxis. Mepyramine did not antagonise the anticoagulant action of heparin in vitro.