Complementary feeding practices in rural area of district Agra.

The study was conducted to assess the prevailing complementary feeding practices. Strikingly 30.9 percent infants were not receiving complementary foods. 21.9 percent mothers initiated complementary feeding at the right age. This was significantly associated with the literacy status of the mothers (p<0.05). 87.1 percent infants were receiving family pot feeding. The complementary foods fed to the infants were mostly (88.6%) of semi-solid consistency. Demand feeding was being practiced by 66.7 percent mothers. The practice of cleaning hands before feeding was very poor with only 17.1%. Thus to conclude the complementary feeding practices were not satisfactory in the rural area of Agra and need to be improved.

Essentials of specifications for activated alumina in defluoridation technology.

Worldwide, fluoride occurs naturally in some aquifers at concentrations above the WHO guideline values or Bureau of Indian Standards or CPHEEO - MUD - GOI parametric values. Fluoride in excess of the permissible limits in drinking water causes a number of endemic conditions referred to collectively as "fluorosis". Endemic fluorosis remains a challenging national health problem in India and Rajasthan is one of the worst affected states in India though a wide range of chemical and physical defluoridation systems were evolved and tried. Still activated alumina is one of the most widely used and liked defluoridation material currently available. Boom in the advanced and versatile alumina technology has opened new vistas to avail the strong potential of selective alumina adsorbents which are application-specific. Non-regenerable and specialty alumina offer tremendous scope to defluoridate drinking water. Indian industries are manufacturing regenerable activated alumina for defluoridation of drinking water. In order to ensure application of an adsorbent, which caters the desired results with minimum interferences, health risks and long service life span, it is inevitable to draw out dimensions which define precisely the attributes of activated alumina. Specifications for activated alumina intended for defluoridation of drinking water, specific operating and performance requirements, and limitations expressed by critical analysis of cardinal characteristics pave way for adoption of acceptable specifications and code of practice at national level.

Peri-operative management of patients for video assisted thoracoscopic thymectomy in myasthenia gravis.

Three patients of myasthenia gravis, who under went video-assisted thoracoscopic surgery (VATS) were given general anaesthesia by propofol infusion and muscle relaxation by atracurium infusion. Isoflurane was added to control depth of anaesthesia on the basis of haemodynamic changes during surgery. One lung ventilation (OLV) was achieved by placement of Carlens left sided double lumen bronchocatheter. Right-sided surgical approach was used to perform thymectomy. Contrary to claimed short duration of surgery, in first patient, OLV lasted for 10 hours 30 minutes and patient developed re-expansion pulmonary oedema. OLV in second and third patient was for six hours thirty minutes and three hours 45 minutes respectively. Morning dose of pyridostigmine was omitted and atracurium (0.1 mg/kg) was found to be satisfactory for intubation and relaxation was maintained with atracurium infusion to get desired monitored effect. We could not extubate our patients due to longer duration of surgery and the sequelae there off. Post-operative elective ventilation and spontaneous weaning off the atracurium effect was thus preferred.

Reproductive tract infection in women of reproductive age group in Sitapur/Shahjahanpur District of Uttar Pradesh.

CARE India with its UP Office has initiated demand generation and acceptability of services for reproductive health and birth spacing services at community level in two districts in the state of Uttar Pradesh. A total of 3,49,000 women of reproductive age will benefit from participation in program activities over the next five years. Out of total surveyed population of 3662, 798 women of reproductive age group were identified of whom 272 were found to be symptomatically positive in relation of STDs/RTIs giving the overall prevalence rate of 34%. Clinical as well as the microbiological examination was carried out on 193 of these 272 women in field conditions. Those found clinically and/or microbiologically positive were provided treatment and preventive advice. Total of 150 (77.7%) women were diagnosed on the basis of symptoms (syndromic approach) and 151 (78.2%) were diagnosed on the basis of clinical examinations. However, 137 (70.9%) were confirmed microbiologically positive. A large extent was found in the age group of 15 to 24 years. Confirmed cases were comparatively less among nulliparous women (63.6%) than multipara (73.2%) cases. 64.1% women were having watery discharge while 29.1% were having complaint of curd discharge. The discharge was offensive in only 1.9% cases while 4.9% reported mixed discharge. 54.4% women complaining of vaginal discharge were suffering from PID. The discharge were either bacterial alone (26.1%) or bacterial mixed with candidiasis (16.5%) or trichomoniasis (8.7%). Compared to syndromic approach, an improvement in the sensitivity (81.8%) and predictive accuracy (74.1%) was noted when cases were detected with the help of clinical examination.

A study of myasthenia gravis in patients with and without thymoma.

This study was undertaken to compare the clinical, neurophysiological, radiological and prognostic features of myasthenia gravis with and without thymoma. 37 patients with myasthenia gravis (27 males, 10 females), with age range of 4.5 to 72 (mean 39) years, were managed at a tertiary care centre in India. Four patients were below 15 years of age and 6 above 55 years. Most of the patients were in stage II (34). There were 2 patients in stage III and 1 in stage I. 27 patients underwent thymectomy. Thymoma was detected in 10 cases. The decrement in patients with thymoma ranged between 11 and 62% (mean 27.9%) and nonthymoma group 10-75% (mean 28%). CT scan of thorax revealed mediastinal mass in 5 out of 10 cases of thymoma and 2 out of 27 patients without thymoma. Outcome of myasthenia gravis with thymoma was worse than without thymoma at 1 year followup. Severity of illness, extent of decrement, lack of facilitation, duration of illness and age of the patients were not related to the outcome. It is concluded the clinical and neurophysiological changes in myasthenia gravis with and without thymoma do not differ. However, patients with thymoma have a worse outcome.

Serotypes & biotypes of Campylobacter jejuni & C. coli from diverse sources in Calcutta.

C. jejuni and C. coli isolates from diverse sources in Calcutta were serotyped and biotyped according to the Lior scheme. Of the 55 strains examined, 85.5 per cent reacted with one or another of the 73 antisera available. This included the formation of two new serogroups, LIO 67 and LIO 76. C. coli serogroup LIO 46 biotype II was the most frequently encountered strains (14.5%), followed by C. coli serogroup LIO 29, 55 biotype II (10.5%) and C. jejuni serogroup LIO 54, biotype I (5.5%). Serogroups recovered from animals and birds were also found to be prevalent in strains isolated from clinical sources, confirming the zoonotic implications of the disease.

Role of traditional healers and indigenous medical practitioners in health care.

Nearly three-fourth of the indigenous medical practitioners (74.37%) in the rural area of Agra were treating 15 patients in a day. Maximum number of patients was attended by trained practitioners. Only 21.82 percent of the practitioners were providing preventive services apart from curative services. Inspite of wide variations in level of training with consequent difference in knowledge, skills and practice, these practitioners still make a significant contribution to health care of the community provided they get some training of modern health system and state patronage. To start with, at least they should be given orientation towards vaccination as they are still giving tetanus toxoid only at the time of injury. In the same way training should be given regarding distribution of vitamin 'A' for prevention of night blindness and iron folic acid tablets for control of anaemia in vulnerable groups.