Emergency Medical Service (EMS) Belt

Background:Emergency medical service has been a well-know n subject of discussion in India where the population is vast and the health care system is inadequate. Essential drugs are a category of drugs that are needed during the golden hour of saving a patient’s life. It becomes necessary that time, when a simple drug can save the life of a patient, a competent health care provider, is needed to administer the drug to the patient. In such a situation, any health care provider in the vicinity of the person who needs medical assistance must get an alert so that the health care provider can reach the site of the emergency and provide assistance. EMS belt is a system in which with the help of a mobile application, any person in case of a medical emergency can get service from a nearby health care provider within a few minutes. The concept is to raise an alarm alerting the nearby health care practitioners about the person in need of medical assistance. This concept is promising with the advantage that it doesn’t need any special manufacturing of the device. Conducting trials on this concept shall yield good observations and produce hopes for a cost-effective EMS system in India.

Study on Physico-chemical Properties of Kokum Seed (Garcinia indica) Full Fat Flour and Defatted Flour

Kokum (Garcinia Indica)is an ancient fruit of India which is mostly consumed in the form of sarbat. It is mainly found in the western ghats in the state of Maharashtra, Goa, Karnataka, and Kerala. Kokum fruit is widely used in culinary, pharmaceutical, nutraceuticals uses. Kokum has a long history in Ayurvedic medicine as it was traditionally used to cure sores, dermatitis, diarrhoea, dysentery, ear infection and to facilitate digestion. The present study conducted to study Physico-Chemical Properties of Kokum Seed (Garcinia indica) Full Fat Flour and Defatted Flour and it reveals that defatted kokum seed flour is superior in quality in terms of protein, carohydrates, crude fiber and Vitamin B3 contain as compared to kokum seed flour. We can utilise the Kokum seed defatted flour to overcome protein malnutrition problems in developing countries

A cohort study on risk factors for preterm births in rural Gujarat

Background: Prematurity is one of the leading causes of neonatal and under-five mortalities globally and also in India. It is an important determinant of short- and long-term morbidities in infants and children. Unfortunately, risk factors of majority of preterm births (PTBs) remain unexplained which calls for appropriate action. There is a dearth of community-based research on PTB and its risk factors, especially in high burden countries like India. Objectives: The objective of the study was to explore different risk factors for PTB. Methods: A cohort of 1977 antenatal mothers was enrolled at household level by trained field investigators and was followed up in four districts of Gujarat, India, to document the outcome of pregnancy. Pretested and structured questionnaires were used to collect information. A hierarchical regression model was used to analyze the risk factors for PTB. Results: Proportion of PTB was 9% among the enrolled cohort. Risk factors which were found to be significant on applying the hierarchical model were periodontal disease, long sleep duration, and sex during any trimester. Conclusions: The study suggests an urgent need for strengthening of existing guidelines for effective, evidence-based, and culturally appropriate interventions for prevention of PTB. Maintenance of good oral hygiene should find a place in routine recommendations for pregnant women, and antenatal examinations should include screening for oral hygiene also.

Evaluation of real-time reverse-transcription loop-mediated isothermal amplification assay for clinical diagnosis of West Nile virus in patients

Background & objectives: West Nile virus (WNV) is a mosquito-borne flavivirus. The disease can be diagnosed by isolation followed by fluorescent antibody tests, enzyme-linked immunosorbent assay and polymerase chain reaction (PCR) assay. These diagnostic methods are laborious and time-consuming. The present study was aimed to evaluate the real-time reverse-transcription loop-mediated isothermal amplification (RT-LAMP) method for rapid, early and accurate diagnosis of WNV. Methods: A one-step single tube accelerated quantitative RT-LAMP assay was evaluated by targeting the Env gene of WNV. The gene amplification was accomplished by incubating the reaction mixture at 63°C for 60 min in both real time turbidimeter as well as routine laboratory water bath/dry heating bath. To rule out contamination issues, proper negative controls, including no template, no primer; and no enzyme, were always kept alongside each run. The RT-LAMP assay was evaluated on 105 clinical samples from individuals having ocular infection. Results: Of the 105 samples tested, 27 were positive for WNV by RT-LAMP assay. The comparative evaluation with conventional RT-PCR revealed 100 per cent accordance with sensitivity and specificity of 100 and 95 per cent, respectively. The specificity of this assay was confirmed with serum samples obtained from patients with dengue and chikungunya. Interpretation & conclusions: The RT-LAMP test seemed to be a sensitive and specific method for rapid detection of WNV infection and would be useful for rapid screening of a large number of clinical samples in endemic areas during outbreaks.

Study to determine the prevalence of urinary tract infection and to identify the causative organism and their antibiotic sensitivity pattern in severe acute malnourished children

Background: Malnutrition generally implies under-nutrition and refers to all deviations from adequate and optimal nutritional status in infants, children and in adults. In children, under-nutrition manifests as underweight and stunting (short stature), while severely undernourished children present with the symptoms and signs that characterize conditions known as kwashiorkor, marasmus or marasmic-kwashiorkor. Materials and methods: The present study was carried out in the department of pediatrics and microbiology at UP Rural Institute of Medical Sciences and Research, Saifai, Etawah (U.P) during April 2014 to March 2015. Total 85 children were included in study. Results: Although under reported UTI is common in children with SAM as came out in our study. Prevalence of UTI is common (22.4%) in children with SAM in our study. In our study, Urinary tract infection was more common in females than males in SAM children with maximum prevalence among 37-59 months of age .but there is no significant difference between sex. Sharma IK, Garg KK, Saxena D, Sharma N. Study to determine the prevalence of urinary tract infection and to identify the causative organism and their antibiotic sensitivity pattern in severe acute malnourished children. IAIM, 2017; 4(7): 89-104. Page 90 Conclusion: Most sensitive first line oral Antibiotic was Nitrofurantoin and parentral antibiotic was Amikacin for UTI in children with SAM, in our study.

Accuracy in Estimation of Gestational Age in Third Trimester by Fetal Kidney Length in Indian Women.

Introduction: Accuracy in estimation of gestational age (GA) has become more demanding as technology used in sonography has become more advanced. Patient’s expectations have also increased and they expect exact estimations to plan their pregnancies. Fetal kidney length (FKL) alone or in combination with other biometric indices can be used in estimating GA more precisely. Objective: The study aimed in measuring FKL and calculating GA using it as a single parameter and comparing the accuracy when combined with other biometric parameters used in estimation of GA on ultrasonography in third trimester in Indian women. Material and methods: Healthy pregnant women in third trimester with single live fetus with no maternal or fetal complications were selected for the study. FKL along with other biometric parameters were measured. The results were analyzed for finding if FKL could be used as a single parameter in estimation of GA and if the accuracy improved if combined with other indices. Results: GA was estimated in 715 cases by all four parameters in the women who came in the third trimester for ultrasonography. FKL was also measured simultaneously in these women. It was observed that average FKL increased linearly from 30.7 mm at 27 weeks to 39.4 mm at 38 weeks. Mean left kidney length was slightly but significantly more than the right kidney. GA was estimated by FKL alone and it gave results with SE ± 10.45 days and when combined with other indices accuracy improved to SE ± 5.45 days. Conclusion: FKL can be a single lone parameter in estimation of GA to give an accuracy of SE ± 10.45 days, but when used in combination with other four indices the accuracy increased to SE ± 5.5 days.

Fetal Femur Length in Assessment of Gestational Age in Third Trimester in Women of Northern India (Lucknow, UP) and a Comparative Study with Western and Other Asian Countries.

Introduction: Gestational age (GA) estimation is the most important part of obstetric practice and ultrasonic study plays an important role in its accurate estimation. Fetal femur length (FL) is one of the parameters used for estimation of GA along with biparietal diameter, head circumference and abdominal circumference (AC). Objective: This study is an attempt to correlate fetal FL with GA and to ascertain if fetal FL can be used as a parameter to calculate the GA in third trimester of pregnancy in Indian women with moderate accuracy. Findings have been compared with the work of sonologists from other countries. Material and methods: Pregnant women in the third trimester of pregnancy with single live fetus and having no other complication either in mother or fetus, were selected for the study, fetal FL along with other parameters was measured. The results were analyzed for accuracy in estimation of GA by FL and were compared with findings of other workers. Result: GA estimated from FL in 512 cases between 27-39 weeks of gestation showed that quadratic model has a good fit to the data and r2 = 0.785 with standard error + 8 days. There was a significant difference with Iranians and Bangladesh women in comparison to our findings. The paired t-test between Indian and Bangladesh, women was significant, (p < 0.001). The findings in our study were similar to the results of Western fetal FLs. Conclusion: The data can be useful in estimation of GA by FL. Our error was + 8 days. A bigger study involving same number of cases in each week of gestation in third trimester is necessary to get an accurate formula for assessment of GA by FL.

Use of antimicrobial agents and granulocyte colony stimulating factors for febrile neutropenia in cancer patients in a tertiary care hospital in India.

Background: Use of antimicrobials (AM) and granulocyte colony stimulating factors (G-CSF) affect the outcome and cost of treatment of febrile neutropenia (FN). There are no studies describing the AM utilization pattern or the use of G-CSF and cost incurred on them in cancer patients with FN from India. Materials and Methods: A study was conducted in a tertiary care, teaching hospital in New Delhi, India, with the objectives of describing the utilization pattern of AM and G-CSF in cancer patients with FN. The efficacy and costs of AM and G-CSF prescribed were also assessed. Results: A total of 211 patients with FN were enrolled in the study. A majority of 207 (98.1%) were in the low-risk category. The average number of AM used per patient was 2.45 ± 0.02 and the AM exposure density was 1.19. All patients were administered five different combinations of AM regimens and G-CSF, irrespective of the risk category. No difference in the time to defervesence or in the recovery of ANC counts were observed with the different AM regimens. The average drug cost per febrile neutropenia episode (FNE) was Rs 4694.45 ± 296.35 (113.95 ± 7.19$). G-CSF accounted for 76.14 - 97.58% of the total costs. Conclusion: Large variations in the pattern of AM prescribed with routine use of G-CSF, irrespective of the risk status, was observed. Guidelines for the rational and cost-effective use of AM and G-CSF in patients with FN needed to be prepared. This was especially important as treatment was given free of cost to all patients admitted in the government health facility.

Biomonitoring of metal deposition by using moss transplant method through Hypnum cupressiforme (Hedw.) in Mussoorie.

Metals Cu, Zn, Cd and Pb were surveyed at 14 sampling sites by using moss Hypnum cupressiforme through active monitoring technique. Samples were transplanted in all four directions of Mussoorie city and were harvested after exposure of four months (representing each season) to analyze metal precipitation and its trend at different sites during 2005. Bioaccumulation ability for metals was evaluated seasonally exhibiting maximum in summer followed by winter and minimum in rainy season. However, at some places Cu shows highly significant values in rainy season in comparison to winter. In case of Zn and Pb significantly different (p < or = 0.05) values were observed between summerand rainy season. Baseline concentration of Cu, Pb and Zn was significantly different at 5% in comparison to other transplant sites. Result indicates Dhanaulti as most polluted location might be due to higher tourist activity and vehicular load, whereas, same was found low at Chamba might be due to place was free from pollution sources or away from in proximity to road and have low human interference. The present study allows us to determine the extent of the area affected by metal precipitation load in different rural and urban areas and abundance of metals in order of Zn > Pb > Cu > Cd.

Overcrowding and health.

The present study correlates the disease profile of 2536 persons belonging to 542 families with the available per capita floor area (PCFA). It was observed that 91.9 percent individuals were living in overcrowded conditions. As the PCFA decreased, the communicable diseases, infective and parasitic diseases and respiratory disease episodes exhibited a significant increase.

Internet: a major resource for toxicologists.

Use of the Internet in developing countries is now growing faster. Internet has created a new conduit not only for communication but also in the access, sharing and exchange of information among scientists. The Internet is now viewed as the world's biggest library where retrieval of scientific literature and other information resources are possible within seconds. Large volumes of toxicological information resources are available on the Internet. This review outlines some sites that may be of great importance and useful to the toxicologist.

Removal of copper by Pseudomonas putida strain S4 isolated from copper mines.

A bacterial strain, Pseudomonas putida S4, was isolated from smelter drainage of copper mines. The strain exhibited resistance to several heavy metals, like aluminium (Al), zinc (Zn), nickel (Ni), cobalt (Co) besides copper (Cu). Strain S4 could accumulate Cu from the Cu-supplemented growth medium. In the present study, we have demonstrated the Cu2+ removal capacity of this strain from various samples such as mine effluent, low-grade ore and ore-tailings, collected from the mining site. Moreover, approximately 80% of the accumulated Cu2+ could be recovered from the loaded biomass by a simple desorption procedure.

Trends and determinants of immunisation coverage in India.

The 20th century has witnessed many important events in the control of infectious diseases that mostly affect children. In addition to the eradication of smallpox, the interruption of poliomyelitis transmission in many countries with a distinct possibility of its eradication by the turn of this century are some of the major achievements. Also, the rates of other vaccine preventable diseases such as measles, pertussis and diphtheria have gone down significantly. The discovery and use of vaccines have made it possible to save approximately 8 million deaths, annually. This is in addition to the reduction in millions of children's suffering and disability. It is now important to build on these gains through adequate utilisation of other vaccines e.g., hepatitis B, typhoid and Haemophilus influenzae type b that are currently available, but in limited use. But, a high level of coverage for any vaccination programme is a pre-requisite to witness the effective reduction of the specific disease against which child population is vaccinated. This paper reviews the coverage levels by surveys in the last 3 years. It has been observed that vaccination coverage levels are falling. Keeping the promises of immunising every child to fulfill his/her right is the need of the hour. To achieve this the major action points are: (a) The need for organising fixed immunisation sessions at the community, where low proportion of sessions are held; and (b) The need to improve demand generation activities where the coverage is poor despite better service availability at the community level. Therefore, the challenge for the next century is to make sure that the enormous impact of vaccines on the health and well-being of the population is maintained as well as expanded. Vaccines that effectively prevent rotavirus diarrhoea, pneumococcal pneumonia, menigococcal meningitis, if made available, could prevent deaths up to two million a year. Research efforts are currently under progress to develop new vaccines against malaria, tuberculosis, shigella-induced dysentery, and Esch coli-induced diarrhoea.

Effect of hexachlorocyclohexane on hsp26 expression in transgenic Drosophila melanogaster.

Hexachlorocyclohexane (HCH) at different concentrations (0.5 to 5.0 ng/ml) mixed with food was fed to third instar larvae of hsp26-lacZ transgenic Drosophila for 2 hr and hsp26 gene expression was examined by beta-galactosidase staining. Puffing in salivary gland polytene chromosomes was also studied. Brain and midgut of larvae showed dark blue staining at 2.0 and 5.0 ng/ml of HCH. Absence of induced puffing at 67B and 84D in the salivary gland polytene chromosomes indicated that these glands are not affected. The study suggests presence of the vulnerable sites in larvae to the higher concentrations of HCH.

Meningococcal meningitis in an industrial area adjoining Surat City--some clinico-epidemiological aspects.

An industrial area with poor sanitation and inhabited by migrant, male predominant population, situated South to Surat City, experienced an outbreak of pyogenic meningitis during 1985-87. A total of 197 cases of meningitis with 34 deaths were reported during a period of 1 1/2 years. Neisseria meningitidis was the predominant pathogen isolated from 66 out of 138 CSF samples. Recently migrated males of productive age groups drawn from the States of Uttar Pradesh and Orissa were predominantly affected. Male to female ratio was found to be 7.2:1. Nearly 2/3rd of the cases were reported during the dry colder months of winter and spring. Pregnancy and childbirth appeared to be important predisposing factors in females. Nine cases were reported from the family contacts of cases. Majority of the cases were labourers doing manual work.