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This paper scrutinises the Supreme Court Judgment of May 2, 2022, in a vaccine mandate-related petition. The Hon'ble Court’s Order reasserts the primacy of right to privacy and Articles 14 and 21 of the Constitution of India. However, in the interest of protection of communitarian health, the Court felt that the Government is entitled to regulate issues of public health concern by imposing certain limitations on individual rights, which are open to scrutiny by constitutional Courts. However, such mandatory vaccination directives with preconditions cannot invade an individual's right to personal autonomy and right to access means of livelihood, and must meet the threefold criteria laid down in K.S.Puttaswamy, a landmark judgment of 2017. This paper examines the validity of the arguments adopted in the Order and suggests certain infirmities therein. Nevertheless, the Order is a balancing act, and worth celebrating. The paper concludes, as a cup that is “a quarter full”, as a victory for human rights and as a safeguard against unreasonableness and arbitrariness in medico-scientific decision-making that takes the citizen’s compliance and consent for granted. If the State runs amok by way of mandatory health directives, this Order may come to the rescue of the hapless citizen
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Stigma-associated psychosocial problems are common in leprosy. Hence, this study aimed to measure the attitudes of people affected by leprosy towards fellow people affected by leprosy in an endemic district in West Bengal, India. A cross-sectional study was conducted among 358 people affected by leprosy above 18 years and married who reported at a tertiary referral hospital in Purulia, West Bengal. A structured questionnaire was prepared to collect the demographic profile, disease profile and attitudes towards the disease. The results revealed that 132 (37%) of the respondents allowed their children to play with a child affected by leprosy, and 279 (79%) of them would not allow their son/daughter to marry a bride/groom with leprosy. Two hundred and thirty-nine (67%) recorded that people affected by leprosy should not have a child, and 203 (57%) were unwilling to work with someone concerned with leprosy. Two hundred and five (57%) said they would not employ someone with leprosy. Further, the female respondents had adopted a more positive attitude towards having a child of their own by people affected with leprosy, willing to work with them and employ them. While gender, age and duration of disease had relationship with attitude, no such association was observed with disabilities. This study indicates the potential usefulness of improving the knowledge about disease through proper education and awareness and develop positive attitudes towards affected people.
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Background: Vitamin A is an essential nutrient needed for normal vision, immune functions, maintenance of epithelial cell integrity, growth and development, reproductive function. It is the most important cause of preventable childhood blindness in developing countries. To estimate the prevalence of vitamin A deficiency in children ?15 yearsAim: reporting to a tertiary care centre A cross sectional study was conducted on 100 children agedMaterials & Methods: upto 15years reporting to eye OPD from April 2022- June 2022. Detailed history from mother was collected. A comprehensive ophthalmic examination including visual acuity measurement, anterior segment, fundus evaluation was done. Vitamin A deficiency was clinically assessed by using WHO classification of Xerophthalmia. TheResults: prevalence of clinical vitamin A deficiency in this study was 9%. Maximum presentation was seen in age group of >2-5 years. Prevention, early recognition by regular screening and nutritional education would decrease theConclusion: risk of developing clinical vitamin A deficiency
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Interstitial lung disease with nephrotic syndrome and junctionalepidermolysis bullosa is caused by biallelic mutations in theintegrin gene ITGA3 and is associated with death in infancy. Wedescribe a variant of this syndrome with delayed presentation ofsymptoms and prolonged survival.
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Purpose: To date, there is no information on the comparison of the effect of 0.5% bupivacaine with 0.75% ropivacaine solution for vitreoretinal surgery. The aim of the study was to compare the efficacy of 0.5% bupivacaine with 0.75% ropivacaine in peribulbar anesthesia for vitreoretinal surgery. This was a prospective randomized double-blinded observational study in a hospital setting. Sixty patients planned for vitreoretinal surgery were randomized into two groups based on the peribulbar injection administered either with 0.5% bupivacaine or 0.75% ropivacaine solution, as Group B (n = 30) and Group R (n = 30), respectively. Time of onset of analgesia, akinesia, and the need for supplemental anesthesia were noted. Student's t-test or Mann-Whitney U test were used for comparing continuous variables and Chi-square or a Fischer exact test were used as appropriate for comparing two proportions. Results: The patients in Group R showed an earlier onset of both, analgesia (1.97 min vs. 2.10 min, P = 0.002) and akinesia (2.77 min vs. 4.20 min, P < 0.001) compared with the patients in Group B. The efficacy of the block attained was Grade 5 (adequate anesthesia and akinesia without supplementation) in about 97% of the patients in Group R while only 90% in Group B. However, the differences between the groups for the efficacy of the block were not statistically significant (P = 0.301) neither for Grades 5 nor for Grade 4 and 3 (P = 1.00 for both). The onset of postoperative pain was similar for both groups (P = 1.00). Conclusion: We concluded that 0.75% ropivacaine is a better choice of local anesthetic solution for patients undergoing primary vitreoretinal surgery compared with 0.5% bupivacaine.
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@#The coronavirus disease 2019 (COVID-19) is highly infectious, with the current pandemic causing significant morbidity and mortality worldwide. As large numbers of frontline healthcare workers (HCWs) have also been infected and several have died, there is much global concern about protective measures for them, particularly those performing surgery or other procedures with close patient contact. Since the beginning of the pandemic, there has been and there remains a shortage in the supply of personal protective equipment (PPE), including the N95 filtering facepiece (FFP) respirator, for HCWs. N95 respirators have filtration efficiency of 95% of aerosol particles. Surgical N95 respirators are used where fluid resistance is also required together with respiratory protection, e.g. during surgery or interventional procedures. The shortage of N95 respirators may be overcome by extended use and reuse - comprising rotation and decontamination by approved techniques. The additional role of powered air-purifying respirators (PAPR) is also discussed.
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Introduction: Scrub typhus is a zoonotic infection caused by Orientia tsutsugamushi which is transmitted by Leptotrombidium mites. The disease manifests as a mild-to-severe illness with non-specific clinical symptoms. Rapid diagnosis and prompt treatment are essential for patient management. Both serological and molecular methods are used for the diagnosis of scrub typhus. The present study assessed the usefulness of detection of the gene encoding the 47kDa outer-membrane protein (OMP) for the laboratory diagnosis of scrub typhus. Materials and Methods: Nested polymerase chain reaction (nPCR) and real-time PCR targeting 47 kDa OMP antigen gene of O. tsutsugamushi were performed on ethylenediaminetetraacetic acid blood samples. Results: Six of the 103 (5.8%) patients showed the presence of 47kDa gene by nPCR. Seventy of 103 (67.9%) cases showed the presence of 47kDa gene by qPCR. Among the 70 positive cases, the majority of them were females (40/70, 57.1%). The highest number of positive cases was observed during October朏ebruary. Conclusion: Real-time PCR targeting O. tsutsugamushi-specific 47-kDa gene is more sensitive than nPCR and may be the assay of choice for the detection of the organism in patients with suspected scrub typhus.
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Purpose: The purpose of this study is to study the benefit of addition of oral fenofibrate to the current regimen of diabetic macular edema (DME) management and quantify its effect on macular thickness and visual function in DME. Methods: Fifty-three eyes of 50 patients were randomized into treatment (Group A) (oral fenofibrate 160 mg/day) and control groups (Group B). Both groups underwent treatment of DME as per the standard treatment protocol of our hospital including intravitreal injections (anti-vascular endothelial growth factor/steroid) and grid laser. Patients were followed up every 2 months to note the visual acuity and central macular thickness (CMT) for 6 months. Results: Our groups were matched with respect to age (P = 0.802), mean diabetic age (P = 0.878), serum HbA1C levels (P = 0.523), and serum triglyceride levels (P = 0.793). The mean reduction in CMT was 136 ? in Group A and 83 ? in Group B at the end of 6 months. This difference was statistically significant (P = 0.031). Visual acuity improvement was 0.15 in Group A and 0.11 in Group B at the end of 6 months (P = 0.186). On subgroup analysis in Group A, we found that there was no difference in reduction of CMT between hypertensives and normotensives (P = 0.916), in patients with normal triglyceride levels and increased triglyceride levels (P = 0.975). Conclusion: Addition of fenofibrate to the standard protocol of DME management seems to facilitate reduction of CMT and probably have an added benefit on the visual functions.
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Dr Ranjit Roy Chaudhury passed away on October 27, 2015 at the age of 85, literally with his boots on. He breathed his last after having just arrived in Chennai to deliver a speech on pharmacovigilance at a local medical college hospital.
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The aim of the present study is to develop a tool to measure the Professional Commitment towards Teaching. So the researcher with the assistance of his guide prepared a questionnaire to measure the Professional Commitment towards Teaching. The tool is constructed in aiming the professional commitment of teachers who work for the Higher Secondary Schools in Salem and Krishnagiri Districts in Tamil Nadu respectively. Since the psychological aspect of any profession is commitment towards profession. Now days teaching profession become more conversed amongst the learned crowd and professionals in the same. Hence the researcher aimed in constructing a tool to measure the Professional Commitment towards Teaching.
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Ceftriaxone , Drug Resistance , Drug Resistance, Viral , Humans , Vibrio cholerae/drug effectsABSTRACT
Between February 13 and March 18, 2011, a total of 18 women lost their lives while admitted in Umaid Hospital and the MG Hospital, Jodhpur, for medical management of their pregnancies. The majority of these women were from villages and all were from weak socio-economic backgrounds. Two of them belonged to families identified as being below the poverty line. Of the 14 women who died in February, eight delivered through lower segment caesarean section. Four underwent hysterectomy. One also had emergency surgery to stop excessive internal bleeding.
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Chandra Mohan Gulhati was born on October 18, 1940, at Karor, District Dera Ismail Khan, in the Punjab (now in Pakistan). His family migrated to Indore during Partition and his early schooling was in Indore, Madhya Pradesh. He completed his MBBS from MGM Medical College, Indore, and was later awarded a post-graduate diploma from the London School of Hygiene and Tropical Medicine, and a Master of Science (in Internal Medicine) in examinations conducted by the Royal College of Physicians, UK.
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Body Height , Child, Preschool , Creatinine/blood , Diagnosis, Differential , Early Diagnosis , Growth Disorders/diagnosis , Growth Disorders/etiology , Humans , Hypertension/etiology , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Kidney Function Tests , Pallor/diagnosis , Pallor/etiology , Renal Dialysis/methods , Respiratory Insufficiency/diagnosis , Respiratory Insufficiency/etiology , Risk AssessmentABSTRACT
Objective. To identify risk factors associated with Persistent diarrhea (PD) and deaths due to PD. Methods. This prospective case control study included 60 children with PD (cases) and 60 children (controls) with acute diarrhoea (AD). Detailed history, examination and appropriate investigations were done for all children. Crude Odds ratio was calculated for each risk factor by univariate analysis and adjusted odds ratio was calculated by multivariate logistic regression. Results. Prior antibiotic use, steroid use, anemia, vitamin A deficiency, malnutrition, LRI, UTI, oral candidiasis, and hyponatremia, were statistically significant risk factors by univariate analysis. Prior antibiotic use, vitamin A deficiency, malnutrition and LRI were independently associated with PD by multivariate logistic regression analysis. The risk factors for mortality were stool frequency more than 10 times per day, severe malnutrition, oral candidiasis, hypoalbuminemia and HIV positivity. Conclusions. The presence of these risk factors should alert the clinician to take appropriate measures, to decrease the mortality.
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Anemia/complications , Anti-Bacterial Agents/therapeutic use , Case-Control Studies , Child , Child, Preschool , Chronic Disease , Diarrhea/drug therapy , Diarrhea/etiology , Diarrhea/mortality , Female , Humans , Hyponatremia , Infant , Logistic Models , Male , Malnutrition/etiology , Multivariate Analysis , Odds Ratio , Prospective Studies , Respiratory Tract Infections , Risk Factors , Vitamin A Deficiency/complicationsABSTRACT
India has over a century old tradition of development and production of vaccines. The Government rightly adopted self-sufficiency in vaccine production and self-reliance in vaccine technology as its policy objectives in 1986. However, in the absence of a full-fledged vaccine policy, there have been concerns related to demand and supply, manufacture vs. import, role of public and private sectors, choice of vaccines, new and combination vaccines, universal vs. selective vaccination, routine immunization vs. special drives, cost-benefit aspects, regulatory issues, logistics etc. The need for a comprehensive and evidence based vaccine policy that enables informed decisions on all these aspects from the public health point of view brought together doctors, scientists, policy analysts, lawyers and civil society representatives to formulate this policy paper for the consideration of the Government. This paper evolved out of the first ever ICMR-NISTADS national brainstorming workshop on vaccine policy held during 4-5 June, 2009 in New Delhi, and subsequent discussions over email for several weeks, before being adopted unanimously in the present form.
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Budgets , Decision Support Systems, Clinical , Evidence-Based Medicine , Humans , Immunization Programs , India , /economicsABSTRACT
Objective. To identify the causes and contributing factors of persistent pneumonia in children. Methods. 41 cases with persistent pneumonia were investigated (biochemical, microbiological, histopathological, immunological and radiological tests) to find out the underlying cause. Results. Out of 41 cases, 8 had pulmonary tuberculosis and 12 had Gram negative bacterial infections, 12 had aspiration due to gastroesophageal reflux disease or oil instillation, 3 had immunodeficiency due to HIV infection, 2 had congenital lung malformation, 2 had cardiac disorders and one had foreign body aspiration as causes of persistent pneumonia. The etiology could not be established in one case. Conclusion. The most common underlying cause of persistent pneumonia were persistent infection followed by aspiration and acquired immunodeficiency.