ABSTRACT
Background: Consumption of iodised salt is a simple, e?ective and inexpensive preventive measure to prevent iodine de?ciency disorders. Lack of awareness, faulty practices in storage as well as poor production quality lead to decreased availability of iodine at consumer level. The objective of the study was to estimate the proportion of households using adequately iodised salt and to assess their awareness and practices regarding iodised salt consumption in a subcentre region of Sarjapur PHC area in Bangalore Urban District.Methods: A cross-sectional study was done in 382 households selected by two stage method involving proportional allocation based on village size followed by systematic random sampling at village level. MBI salt testing kit was used to check for iodisation level.Results: Of the 382 households, 22.3% used inadequately iodised salt. Out of the 382 individuals interviewed, 72% were females and only 21% were aware about iodised salt. Majority of the households purchased salt from a general store, was stored in tightly closed plastic containers and kept on shelves. Only 5% looked for the iodine logo on the packets before purchase of salt. Individuals with poor awareness, purchase of salt at public distribution system store, storage of salt on the floor, use of crystal salt were significantly associated with presence of inadequately iodised salt at the household.Conclusions: Nearly 30% of the salt packets used by households were inadequately iodised. Awareness regarding iodised salt was poor which contributed to the presence of inadequately iodised salt at household level.
ABSTRACT
Background: Non-communicable diseases are the leading causes of death globally, of which cardiovascular diseases are the most common. Cost-effective strategies, such as task shifting, are needed to mitigate the rising epidemic by controlling hypertension and diabetes in our country.Methods: This was a non-randomized interventional study undertaken in six (3 intervention and 3 control) villages of Lakkur primary health centre (PHC) area under Malur taluk, Kolar district, Karnataka, from November 2013 to April 2015. After obtaining written informed consent, baseline survey was done among 180 diabetics and hypertensives (adults>30 years). In the intervention villages, ASHAs who were trained did the intervention for 6 months. In non-intervention villages, standard usual care was given and repeat survey was done after 6 months to re-measure.Results: This study demonstrated that there was an increase of 44.8% in the proportion of hypertensives whose blood pressure was under control and increase of 26.5% in the proportion of diabetics whose blood sugar was under control in villages that received household visits by trained ASHAs (intervention villages). There was an increase in the medication adherence levels (29.6%) and reduction in tobacco usage (median difference of 4 times per day) among hypertensives and diabetics who are on medication in intervention villages.Conclusions: Findings from this study will provide policy makers and other stakeholders needed information to recommend scalable and cost-effective policy in respect to cardiovascular risk reduction, hypertension and diabetes control in resource-poor settings.
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Objective: Stereotactic radiotherapy [SRT] has been increasingly used for treatment of brain metastases in recent years. The goal of this study was to evaluate the clinical outcomes in patients with brain metastases treated with LINAC-based SRT
Methods: Patients who underwent SRT at our institution between 2013 and 2017 were retrospectively analyzed. Treatment plans were generated using either iPlan stereotactic treatment planning system [Brainlab Ag, Feldkirchen, Germany] or Eclipse V11.0.47 [Varian Medical Systems, Palo Alto, CA, USA] and patients were treated on a TrueBeam machine equipped with a robotic couch. The treatment response was assessed using RANOBM criteria. The primary endpoint was local control. Secondary endpoints were distant brain control, overall survival and treatment toxicity
Results: Fifty-six patients [28 males and 28 females] with 100 lesions were identified for this study from July 2013 to November 2017. The median age at the time of SRT was 65 years [range 16-86]. The most common histologies were lung [66percent] and breast [26percent]. Seventeen lesions [17percent] were treated postoperatively. Median GPA score [graded prognostic assessment] was 2.5.Treatment regimens consisted of: 1 fraction [median dose = 20 Gy], 3 fractions [median dose = 27 Gy], 5 fractions [median dose = 30 Gy] and 6 fractions [median dose = 30 Gy] in 27percent, 18percent, 41percent and 14percent of the lesions respectively. The median GTV size was 2.44cc [range 0.1-119.67cc] and the median PTV size was 5.03cc [range 0.32-197.22cc]. At a median follow-up of 9.4 months, 7 patients recurred locally. The 1-year local control rate was 88percent and the mean local control was 33 months. The 1-year and mean distant brain control were 45percent and 16.8 months respectively and the 1-year and mean overall survival were 70percent and 29.5 months respectively. A GPA score > 2 was significantly associated with better overall survival than a GPA score
Conclusion: Our institution experience showed that LINAC-based SRT is an effective local ablative treatment for brain metastases with an excellent toxicity profile
ABSTRACT
About 700,000 Accredited Social Health Activists (ASHA) have been deployed as community health volunteers throughout India over the last few years. The objective of our study was to assess adherence to selection criteria in the recruitment of ASHA workers and to assess their performance against their job descriptions in Karnataka state, India. A cross-sectional survey, using a combination of quantitative and qualitative methods, was undertaken in 2012. Three districts, 12 taluks (subdistricts), and 300 villages were selected through a sequential sampling scheme. For the quantitative survey, 300 ASHAs and 1,800 mothers were interviewed using sets of structured questionnaire. For the qualitative study, programme officers were interviewed via in-depth interviews and focus group discussions. Mean±SD age of ASHAs was 30.3±5.0 years, and about 90% (261/294) were currently married, with eight years of schooling. ASHAs were predominantly (>80%) involved in certain tasks: home-visits, antenatal counselling, delivery escort services, breastfeeding advice, and immunization advice. Performance was moderate (40-60%) for: drug provision for tuberculosis, caring of children with diarrhoea or pneumonia, and organizing village meetings for health action. Performance was low (<25%) for advice on: contraceptive-use, obstetric danger sign assessment, and neonatal care. This was self-reported by ASHAs and corroborated by mothers. In conclusion, ASHA workers were largely recruited as per preset selection criteria with regard to age, education, family status, income, and residence. The ASHA workers were found to be functional in some areas with scope for improvement in others. The role of an ASHA worker was perceived to be more of a link-worker/facilitator rather than a community health worker or a social activist.
ABSTRACT
We transplanted 47 patients with Fanconi anemia using an alternative source of hematopoietic cells. The patients were assigned to the following groups: group 1, unrelated bone marrow (N = 15); group 2, unrelated cord blood (N = 17), and group 3, related non-sibling bone marrow (N = 15). Twenty-four patients (51 percent) had complete engraftment, which was not influenced by gender (P = 0.87), age (P = 0.45), dose of cyclophosphamide (P = 0.80), nucleated cell dose infused (P = 0.60), or use of anti-T serotherapy (P = 0.20). Favorable factors for superior engraftment were full HLA compatibility (independent of the source of cells; P = 0.007) and use of a fludarabine-based conditioning regimen (P = 0.046). Unfavorable factors were > or = 25 transfusions pre-transplant (P = 0.011) and degree of HLA disparity (P = 0.007). Intensity of mucositis (P = 0.50) and use of androgen prior to transplant had no influence on survival (P = 0.80). Acute graft-versus-host disease (GVHD) grade II-IV and chronic GVHD were diagnosed in 47 and 23 percent of available patients, respectively, and infections prevailed as the main cause of death, associated or not with GVHD. Eighteen patients are alive, the Kaplan-Meyer overall survival is 38 percent at ~8 years, and the best results were obtained with related non-sibling bone marrow patients. Three recommendations emerged from the present study: fludarabine as part of conditioning, transplant in patients with <25 transfusions and avoidance of HLA disparity. In addition, an extended family search (even when consanguinity is not present) seeking for a related non-sibling donor is highly recommended.