Community perspectives on alcohol use among a tribal population in rural southern India.

Background. Alcohol use is common in many cultures. Excessive use of alcohol adversely impacts individuals, families and communities. Medicine, which uses biomedical models and perspectives, views alcohol dependence as a disease. Alcohol use and dependence are complex societal problems, which need to be viewed through multidisciplinary approaches and corrected by adopting intersectoral efforts involving local communities. Methods. We used qualitative methods such as focus group discussions and in-depth interviews to document perspectives on alcohol use among a tribal community in southern India. We recorded traditional norms, changing patterns of use of alcohol and its consequences for individuals, families and the community. Results. Eight focus group discussions and eleven in-depth interviews were conducted. Though consumption of alcohol is part of the local culture, changes in occupation and availability of alcohol has made its consumption a problem. The introduction and easy availability of Indian-made foreign liquor, which is stronger than the locally brewed variety, in government-run outlets has changed the culture of drinking at festivals to drinking more often. This leads to public fights, domestic violence and increasing mortality and morbidity due to road traffic incidents and ill health. The age of initiation into drinking has decreased. Conclusion. The introduction of non-traditional and commercial alcohol use has put a heavy price on tribal and rural people. Community-based interventions targeting young children and adolescents may pay more dividends than pursuing purely medical treatments for problem drinkers.

Melioidosis: A report of two cases.

Melioidosis is increasingly being reported from India in the past few years. Since it can mimic tuberculosis during the initial presentation, treatment with antituberculosis drugs is common. It should be considered in the differential diagnosis of any pyrexia of unknown origin. We report two cases of melioidosis that presented with pyrexia of unknown origin and a localized cutaneous abscess over the chest wall.

Survey of ethical issues reported by Indian medical students: basis for design of a new curriculum.

Education in ethics is now a formal part of the undergraduate medical curriculum. However, most courses are structured around principles and case studies more appropriate to western countries. The cultures and practices of countries like India differ from those of western countries. It is, therefore, essential that our teaching should address the issues which are the most relevant to our setting. An anonymised, questionnaire-based, cross-sectional survey of medical students was carried out to get a picture of the ethical problems faced by students in India. The data were categorised into issues related to professional behaviour and ethical dilemmas. Unprofessional behaviour was among the issues reported as a matter of concern by a majority of the medical students. The survey highlights the need to design the curriculum in a way that reflects the structure of medical education in India, where patients are not always considered socio-culturally equal by students or the medical staff. This perspective must underpin any further efforts to address education in ethics in India.

Birthweight Centile Charts from Rural Community-based Data from Southern India.

Objective: The objectives of the study were to estimate gestational age specific birthweight centiles from healthy pregnancies in a defined rural block and compare the under-two month mortality rates in those belonging to the lowest and highest centile groups. Design: Retrospective chart review. Setting: Routine data collected regarding all pregnancies, births and deaths occurring in Kaniyambadi, a rural block in Southern India, between 2003 to 2012. Subjects: All singleton live newborns of women without known major antenatal risk factors. Main outcome measures: Gestational age- and sex-specific birthweight centile curves were created using the LMS method. Mortality rates for the first two months of life were calculated for those in various centile groups. Results: The median birthweight at term was lower for the study subjects as compared to the median birth weights in the WHO child growth standards 2006, the US and the UK standards. Mortality rates for those with birthweights both below the 3rd centile as well as above the 97th centile higher than for those between 3rd and 97th centiles. Conclusions: While absolute values of birthweights were lower than the WHO 2006 child growth standards there was a J shaped curve of birthweight and mortality. This suggests that in a given population, mortality increases at extremes of birthweights, even if some of these birthweights may be considered normal by other standards.

Measles outbreak in a vaccinated population in Dhankutta.

A measles outbreak occurred in Dhankutta town in year 2056 Falgun to 2057 Baishak (3 months). A total of 130 cases were registered at the Dhankutta District Hospital. A large proportion of the cases had severe disease with complications and were admitted at the hospital. None of the patients registered at the hospital died. Interestingly, 50.0% of cases were in higher age group (10 years and above) which is an unusual trend in developing countries. All the cases gave history of measles vaccination, which points towards the need for investigation of vaccine efficacy and cold chain efficiency.