Knowledge, attitude and practice of pharmacovigilance among medical students

Background: Spontaneous voluntary adverse drug reaction (ADR) reporting is the backbone for the successful functioning of the Pharmacovigilance Programme of India. The aim of pharmacovigilance is to ensure safe and rational use of medicines, once they are released for general use in the society. Targeting the younger doctor for sensitization toward pharmacovigilance is the key to ensure practice of adverse drug reactions (ADR) reporting in clinical practice. The objectives of this study are to evaluate the knowledge, attitude, and practice (KAP) of pharmacovigilance among medical students at LLRM Medical College, Meerut, a tertiary care teaching hospital. Methods: A cross-sectional study was carried out using a pretested questionnaire. The questionnaire was designed to assess the KAP regarding pharmacovigilance. The medical students (2nd year, final year, and interns) were included in the study. Only the participants who gave their consent were included in the study. Results were calculated by proper statistical analysis. Results: The current study was conducted in a LLRM Medical College, Meerut, which included a total of 250 medical students of which 40% 2nd year, 40% final year students, and 20% interns. Most of them (83%) accepted that reporting ADR is necessary, and pharmacovigilance should be taught in detail to health-care professionals. Conclusions: This study demonstrated that knowledge of pharmacovigilance among medical students is improving gradually and pharmacovigilance and ADR reporting needs to be made compulsory, have better, interesting ways to learn and understand it, so that the students can practice it with confidence in their clinical practice.

Role of faith healers in the treatment of severe mental illness in India

Background: The cultural diversity has influenced the beliefs of people regarding health and illness. An aim of the study was to assess the role of faith healers in the treatment of severe mental illness. Methods: It is a retrospective cross-sectional study with convenience sampling technique was used, on 123 caregivers of patients with severe mental illnesses using standardized tools like MINI, BPRS, and YMRS. Results: 41.5% participants firstly contacted faith healer while 86% visited faith healer anytime during the course of illness. 47.2% took treatment from faith healer for <6 months, 21.1% took 6-12 months and 17.9% more than 13 months. 22.8% circulated between faith healer to faith healer, 18.7% from psychiatrist to faith healer and 27.6% from medical professional to faith healer. Conclusions: There is an immense need to create awareness regarding mental illness and treatment options available.

Studies on Selection Indices for Wheat (Triticum aestivum L.) Improvement Using Interrelationship and Path Analysis under Sub-Tropical Conditions of Indore Region

In Rabi 2022–2023 at Central Research Farm, Oriental University Indore, Madhya Pradesh, twenty varieties of wheat (Triticum aestivum L.) were used in this investigation, which was conducted using an RBD design with three replications. Thirteen quantitative characters were used to record data in order to study the relationships and path analysis between the characters. Correlation studies showed that biomass yield (0.891**, 0.511**), number of grains per spike (0.844**, 0.538**), and thousand seed weight (0.544**, 0.359**) exhibited significant positive correlation with grain yield at both genotypic and phenotypic level. Based on mean performance, JW 3020 (343.687 g) displayed the highest grain yield per running meter. At both the genotypic and phenotypic levels, the characters such as days to maturity (-0.473**, -0.609**) showed a negative correlation with grain yield per running meter. Path analysis showed that characters such as days to maturity (-0.005, -0.0055) had negative direct effects on grain yield per running meter at both phenotypic and genotypic levels, and characters like number of grains per spike (0.835, 0.035), biomass yield (0.71, 0.765), and harvest index (0.089, 0.598) had direct positive effects on grain yield per running meter at both genotypic and phenotypic levels.

Farmers’ Perception towards Climate Change and its Effect on Agriculture in Kolar District of Karnataka, India

This study aimed to assess farmers' perception of climate change and its implications for agriculture in Kolar district, Karnataka, during the year 2021-22. Data from 80 respondents were collected using a multi-stage random sampling technique, employing a well-structured, pre-tested questionnaire administered through personal interviews. Descriptive statistics, regression analysis, and Garret's ranking technique were employed for data analysis. The results revealed that 40% of the respondents had been aware of climate change for the past five years, with farmers' personal observations being a primary source of information. Most farmers identified climate change through rising temperatures, irregular rainfall patterns, and increased overall rainfall. Respondents also noted climate change effects on agriculture, such as increased pest and disease occurrences, altered sowing periods, and heightened competition from weeds. Regression analysis indicated that factors such as education, the use of social media, sources of weather information, and farming experience had a positive and significant influence on farmers' perception levels. As a result, this study suggests the development of climate-based advisory services, including weather alerts, climate-resilient crop varieties, adaptation strategies, and enhanced weather forecasting systems by relevant government departments to mitigate the impacts of climate change on agriculture in the region.

Diagnostic efficacy of fine needle aspiration cytology in soft tissue tumors and cytohistological correlation

Background: Soft tissues are the supportive tissue of various organ as well as the nonepithelial, extraskeletal structure. Fine needle aspiration cytology (FNAC) is a rapid diagnostic technique with limited patient morbidity for diagnosing soft tissue tumours. However, FNAC of soft tissue lesion has not been widely used because of concern about its diagnostic accuracy. The difficulties arise in exact typing and diagnosis of low-grade sarcomas. This study was undertaken to study the acceptability and diagnostic efficacy of cytodiagnosis as compared conventional histological diagnosis and determine distribution of soft tissue tumours according to age and sex. Methods: The study was conducted in the department of pathology, RNT Medical College, Udaipur for period of 1 year. FNAC was done in 77 cases of suspected soft tissue tumors. In 51 cases biopsy resorted and HPE carried out. On the correlation of FNAC diagnosis with histopathological diagnosis the sensitivity, specificity, accuracy and positive predictive were calculated. Results: Maximum number of cases noted were in 40 to 60 years of age with wide range of 11 months to 81 years. Male to female ratio was 1.8:1. Out of total 51 cases 38 found benign and rest were found malignant. Lipomas were the commonest soft tissue tumors. Overall sensitivity obtained in the study using cytology as compared to histopathology was 100%, specificity was 67%, positive predictive value was 54%, negative predictive value was 100%. Conclusions: Cytology though with pitfall, can serve as a diagnostic tool especially when a rapid diagnosis is required.

Histomorphological spectrum of meningeal tumours and its association with MIB-1 labelling index

Background: Meningiomas are extremely common, slow growing tumours originating from meningeal covering of brain and spinal cord. They are mostly encountered in middle or later adult life. Females are affected more commonly than males. Grading of meningiomas based on histological features has certain limitations in predicting exact biological behavior hence ancillary studies like immunohistochemistry can be used to predict the nature of the lesion. Methods: This prospective cross-sectional study was conducted in pathology department in our institute. Total 105 cases, diagnosed as meningioma between October 2019 to May 2021 were included in the study. Immuno-staining was performed using MIB-1 antibody against ki67 antigen. Various statistical test methods like chi square test, unpaired t test and spearman’s rho correlation were used to evaluate the significant value. Results: Among 105 patients analysed there were 78.09% females (mean LI 4.01±3.25%) and 21.91% males (mean LI 3.17±2.64%). Mean age of presentation was 53.14 years and most common subtype was transitional meningioma with 51.43% cases. Histological grading revealed 95.24% WHO grade 1 tumor (mean LI- 3.33±2.22%), 4.76% WHO grade 2 (mean LI- 13.80±2.28%) and no case of WHO grade 3. There was correlation between values of MIB-1 LI and histological grade. Some differences for MIB-1 labelling index were found among the subtypes of meningioma of same grade. Conclusions: The MIB-1 is one important tool in addition to routine histological evaluation. High MIB-1 LI indicates higher grade of meningioma.

Assessment of Knowledge, Attitude and Practice related to Tuberculosis among Rural and Urban Community of North India

Tuberculosis is known as one of the long-standing and dominating health problems affecting people and the extent further escalates in a developing country like India. A pre-evaluated feedback structured questionnaire was validated and adopted to get their quantitative data from 424 respondents. In the present study urban respondents (60.8%) gave affirmative responses regarding awareness of TB, especially with mobile media as their major source of information, followed by information from healthcare workers. Rural respondents were less expressed and deficient on knowledge of TB transmission and preventive methods. Prevention practices toward TB are claimed to be high in urban population because 79.48% believed that early diagnosis, prompt treatment and avoiding poor hygiene and crowded environment are effective strategies to cease the transmission of TB. Effective preventive and informative strategies should be employed in rural border areas to make up for the knowledge gap found among rural and urban populations in this study.

Mucormycosis an Emerging Fungal Infection Associated with COVID-19- A Case Report

Introduction: Mucormycosis is an exceptional but rising fungal infection correlated with the COVID-19 disease. COVID-19 positive patients exhibiting severe symptoms admitted in the ICU have an increased susceptibility to develop bacterial and fungal infection. We hereby report a case of oral mucormycosis that is seen in a patient in post COVID-19 infection. Case Presentation: A 65-year-old woman presented to our institution, with the chief complaint of ulceration in her right palate region for the past 7 days along with pyrexia and generalised malaise. The patient reported to have recovered from COVID-19 infection recently. She presented with medical history of diabetes and hypertension for past 8 years. Post recovery from COVID-19 infection the patient developed an ulcer in the hard palate. Treatment: Surgery was done under General anesthesia. Maxillectomy was done with aggressive debridement of necrotic tissue. Bilaterally periosteal flap was approximated and suture was placed. Conclusion: The extensive use of steroids and broad-spectrum antibiotics in COVID-19 treatment may raise the risk of fungal infections. Medical practitioners should be aware of the possibility of invasive secondary fungal infections in patients with COVID-19 infection.

Unusual Case of Secondary Pneumothorax in a Patient of Allergic Bronchopulmonary Aspergillosis (ABPA)

Pulmonary aspergillosis is a well-recognized fungal lung disease caused by the Aspergillus species (especially Aspergillus fumigatus). Allergic bronchopulmonary aspergillosis (ABPA) is milder form of pulmonary aspergillosis compared to other more invasive forms. However, if left untreated, ABPA can cause significant lung damage. We present the case of a 33-year-old man who came with complaints of shortness of breath, chest discomfort, and productive cough. The patient underwent High Resolution Computed Tomography (HRCT) scan of the chest which, suggested the diagnosis of ABPA with secondary tension pneumothorax.

The role of pro-inflammatory cytokines – tumor necrosis factor-alpha and interleukin 6 – in the evolution of diabetic nephropathy: A comparative study

Background: Diabetes is highly prevalent and it is responsible for the increased financial burden on healthcare. Type II diabetes is a more prevalent form of diabetes. Uncontrolled and unsupervised type II diabetes may lead to various microvascular and macrovascular complications which are responsible for high morbidity and mortality. Diabetic nephropathy (DN) is a common complication characterized by the expansion of mesangial cells with thickening of the basement and nodular glomerulosis. TNF-alpha and IL-6 play an important role in causing detrimental changes leading to nephropathy. The study of the role of these inflammatory cytokines in patients with DN may help in the early diagnosis and management. Aims and Objectives: The objectives of this study were to compare the levels of proinflammatory cytokines, TNF-?, and IL-6 in the evolution of DN patients. Materials and Methods: The present study was conducted in the Department of Biochemistry, in collaboration with the Department of Medicine (Nephrology unit); Pt. B.D. Sharma, Post Graduate Institute of Medical Sciences, Rohtak after ethical clearance. Forty patients with DN (Stages 3, 4, and 5) and forty patients with diabetes mellitus without nephropathy were taken up for study after taking informed consent. Results: The mean serum TNF-? levels in cases was 33.05 ± 29.22 pg/mL and in controls was 17.67 ± 12.33 pg/mL. On the basis of unpaired t-test, the difference between the groups was statistically highly significant (P < 0.05). The mean serum interleukin-6 levels in cases was 24.92 ± 30.16 pg/mL (2.95–155.55 pg/mL) and in controls was 6.76 ± 5.82 pg/mL (2.22–35.42 pg/mL). On the basis of the t-test, the difference between the groups was statistically highly significant (P < 0.05). Conclusion: TNF-? and IL-6 may serve as potential biomarkers for patients with DN and also in the development of newer therapeutic modalities for the prevention and treatment of DN.

Effect on the Prevalence of Various Diffuse Parenchymal Lung Diseases due to Paradigm Change in the Guidelines

Background: Diffuse parenchymal lung diseases (DPLDs) have gone through various changes in nomenclature and classification since they were first described in 1868. Increasing knowledge about their etiopathogenesis has since led to several reclassifications and changes in the nomenclature. This has had a major impact on the prevalence of each interstitial lung disease (ILD) reported by the different registries worldwide. In this study, we attempted to describe the distribution of the different DPLDs in our population and reported changes in prevalence due to changing diagnostic criteria for the disease. Materials and methods: We analyzed retrospective data of 434 patients. For the initial 75 patients, ATS/ERS guidelines published in 2002 were followed in the diagnosis of the ILD (group I). In the later part of the study (359 patients), the diagnosis was based on the computed tomography (CT) patterns defined by ATS/ERS/JPS/ALAT statement on diagnosis of idiopathic pulmonary fibrosis (IPF) and updated 2013 ATS/ERS guidelines (group II). Results: Of the 75 patients in group I, IPF was the most common diagnosis (52%) made at that time, followed by sarcoidosis and connective tissue-related ILD (CTD-ILD) with 12% each. Group II had 359 patients, with IPF again being the most commonly diagnosed ILD with 21.3%. This was followed by CTD-ILD (18.6%), sarcoid (14.7%), and idiopathic nonspecific interstitial pneumonitis (iNSIP; 13.3%). The changing guidelines have an impact on reporting of different DPLD by our multidisciplinary teamover a period of time. Though IPF was the most commonest DPLD reported among both the groups, the diagnosis of IPF had fallen by more than half in the second group. It was paralleled by an increase in the diagnosis of iNSIP and chronic hypersensitivity pneumonitis. These reported changes in the prevalence of DPLDs may reflect the better-defined criteria in the latest guidelines and a better understanding of the fibrotic ILDs other than IPF by the multidisciplinary team. Conclusions: The frequency of diagnosis of the different DPLDs has changed, following the publication of several guidelines in the last decade. It has recognized newer entities with greater clarity, such as idiopathic NSIP and interstitial pneumonia with autoimmune features.

Objective-structured clinical examination in cardiovascular system for the assessment of internal medicine postgraduates amidst the Covid-19 pandemic

BACKGROUND The Covid-19 pandemic has posed a challenge to organizing a safe clinical assessment for postgraduate degree candidates completing the residency programmes in various specialties. Although minimizing the risk of Covid-19 transmission is a priority, fulfilling the objectives of the assessment is equally important. METHODS We conducted this study in the Department of Internal Medicine at our institute. Instead of physically examining patients, case scenarios that included history, clinical and investigational data of the cardiovascular system (CVS) were presented to the candidates. Performance was scored by both the conventional and the CVS objective-structured clinical examination (CVS-OSCE) method and compared. RESULTS Clinical assessment examination of 27 candidates for the degree of Doctor of Medicine showed that the median cumulative score gained in narrating and analysing various differential diagnoses was lower compared to the mean cumulative score gained in arriving at a single correct diagnosis (50% [interquartile range—IQR 39%–64%] v. 79% [IQR 64%–100%], p<0.01). Most of the candidates agreed that case scenarios were good alternatives to the conventional physical examination amidst the pandemic. CONCLUSION CVS-OSCE-based assessment using structured case scenarios is a feasible and effective alternative for clinical skill assessment in high-stake examinations.

Diabetes mellitus in the Tamil Nadu State—Noncommunicable diseases nurse model in diabetic retinopathy screening

Tamil Nadu is one of the states in India, where the diabetic retinopathy (DR) project was implemented in the Tirunelveli District. Aravind Eye Hospital, Tirunelveli was the mentoring institution and ophthalmology department of Tirunelveli Medical College and Hospital (TVMCH) was the implementing partner. The objective of the project was to develop a district level model for building capacity at the government health system for effective screening, diagnosis and management (primary to tertiary) of diabetic retinopathy. The DR screening, counseling, referral and follow-up tasks were included in the scope of Non- Communicable Disease (NCD) nurses at the respective Community Health Centres and Primary Health Centres using the tele-medicine platform. During the project period (December 2016 to June 2019), 8,574 people with diabetes were registered at the 18 CHCs/PHCs. 6,462 (75.4% of those registered) were screened by NCD staff. The government has agreed to scale up services in 3 more districts.

Uterine tumor resembling ovarian sex cord tumor: A series of six cases displaying varied histopathological patterns and clinical profiles

Introduction: Uterine tumors resembling ovarian sex cord tumor (UTROSCT) are a unique group of neoplasms with diverse morphology and immunophenotypic characteristics, coexpressing sex cord, epithelial, and smooth-muscle markers. To date, less than 100 cases have been reported and there is paucity of data concerning their clinical behavior. Materials and Methods: All cases of uterine body tumors diagnosed over a period of two and a half years (2016-2018) were retrieved. Histopathological features were reviewed and extended panel of immunohistochemistry was performed to identify cases of UTROSCTs. Results: Six cases of UTROSCTs were identified with a median age of 46.5 years. Four of them presented with menorrhagia, while two with postmenopausal bleeding including one with a history of carcinoma breast. Three of these cases were initially misdiagnosed as endometrial stromal sarcoma and adenocarcinomas. They all underwent hysterectomy with bilateral salpingo-oophorectomy. Conclusion: It is considered a tumor with low malignant potential; however, one out of six cases (16.7%) in our study showed metastasis, within 1 year of diagnosis. It is important to recognize this entity as it mimics a wide range of both benign and malignant tumors. Molecular pathogenesis and exact management protocols remain elusive due to rarity,hence, multi-institutional studies are warranted.

Effect of papaverine on left internal mammary artery flow: topical spraying versus perivascular injection method

Abstract Objective: To analyze two techniques of papaverine application, topical spray on the harvested left internal mammary artery (LIMA) and perivascular injection, to find out their ability to improve LIMA flow. Methods: Forty patients were randomized into two groups. In Group 1, papaverine was sprayed on the harvested pedunculated LIMA. In Group 2, papaverine was delivered into the perivascular plane. Drug dosage was the same for both groups. LIMA flow was measured 20 minutes after applying papaverine. Blood flow was recorded for 20 seconds and flow per minute was calculated. The systemic mean pressures were maintained at 70 mmHg during blood collection. The data collected was statistically evaluated and interpreted. Results: The LIMA blood flow before papaverine application in the Group 1 was 51.9±13.40 ml/min and in Group 2 it was 55.1±15.70 ml/min. Statistically, LIMA flows were identical in both groups before papaverine application. The LIMA blood flow, post papaverine application, in Group 1 was 87.20±13.46 ml/min and in Group 2 it was 104.7±20.19 ml/min. The Group 2 flows were statistically higher than Group 1 flows. Conclusion: Papaverine delivery to LIMA by the perivascular injection method provided statistically significant higher flows when compared to the topical spray method. Hence, the perivascular delivery of papaverine is more efficient than the spray method in improving LIMA blood flow.

Effect Of Socio-Economic Status On Physical Activity In Community Dwelling South Indian Older Adults

Introduction: Different patterns of activities were reported due to different cultural attitudes of the individuals. Socio-economic status should be taken into consideration when exploring the effect of socio-economic status on health over the life course. Available literature brings out limited studies on socio-economic status and its association with physical activity. In view of above, present study was undertaken to determine an association between selected demographic variables, BMI and physical activity, among older adults, in south India. Materials and Methods: Present study is a community based cross-sectional study, undertaken among older adults (> 55 years and above). Purposive sampling method was used to select the study subjects. A total of 63 older adults were included in the study. The study was conducted over a period of one and half years from 01 January 2018 to 30 June 2019, in selected urban and semi-urban areas in Dakshina Kannada district, Karnataka (India). Results: The study comprised of a total of 63 older adults which included 32 (50.79%) males while remaining 31(49.20%) were females. The physical activity levels were found to be highest (33.33%) in 55-60 years age group while these were lowest (0.00%) in 75 years and above, age group. The association between physical activity and age, was found to be statistically significant. (p value= 0.015) Discussion: In our study, out of 21 older adults from middle SES class 13 (61.90%) were found to be having low physical activity, while in lower SES group out of 21 subjects 9 (42.85%) were found to be having high physical activity levels. However, the subjects from upper SES group, revealed low levels of physical activity as only 02(09.52%) out of 21 subjects showed high levels of physical activity. Conclusion: Present study brings out significant association between physical activity and BMI, while no association was observed between socio-economic status and physical activity. Further, low levels of physical activity were observed across all SES groups,

Collagen fibers in oral submucous fibrosis - A polarizing microscopy study using two special stains

Background: Oral submucous fibrosis (OSMF), a well-recognized oral potentially malignant disorder, results due to increased collagen production and reduced collagen degradation. Aims and Objectives: To qualitatively compare the staining properties of collagen in OSMF using two special stains based on their birefringent property using polarizing microscopy. The study also assessed the distribution and orientation of collagen fibers in different grades of OSMF. Materials and Methods: A total of 73 subjects with different clinical and histopathological staging of OSMF comprised the study population. Histopathological examination was done using hematoxylin and eosin stain, Van Gieson and picrosirius red. Collagen fibers were analyzed for polarization colors, distribution, and orientation. Results: Picrosirius red stained both thick and thin collagen fibers. Irrespective of the histopathological grades reddish orange and yellowish orange were the most predominant colors. Parallel arrangement of fibers was observed when stained with Van Gieson but picrosirius red stained sections showed a majority of parallel type I fibers with perpendicular type III fibers which increased with advancement in the histopathological grade. Yellowish orange and greenish yellow fibers were predominant in the lamina propria, while reddish orange fibers were predominant in the submucosa. Conclusion: Picrosirius red was found to be a better stain. Histopathological grading and polarization colors showed no association with each other. Collagen fibers were more thickly and tightly packed in the submucosa indicating that the process of fibrosis began there. The increase in perpendicular type III fibers with advancing histopathological grades suggested their role in fibrosis.

Adding bit of esthetics with science modification of batwing mastopexy for breast conservation in a young patient with giant fibroadenoma breast

A 19-year-old girl presented with a lump in her right breast and with a history of surgery for the similar complaint 3 years back. Ultrasound was suggestive of benign solitary lesion of size 16 cm × 10 cm. Core biopsy was suggestive of phyllodes tumor, and the histopathology report of previous surgery was also suggestive of phyllodes tumor. Wide excision of the tumor and reconstruction was done with batwing mastopexy and with a slight modification of the described technique so that to avoid contralateral reduction mammoplasty in a young unmarried girl. Postoperative histopathology was suggestive of fibroadenoma measuring 15 cm × 8 cm with all margins free of tumor, and it is probably one of the biggest fibroadenomas reported so far. On follow-up, no significant disparity noted between the appearances of both breasts

Long-course versus short-course palliative cranial irradiation in brain metastases: a comparative study

Background: Brain metastases are the most common intracranial malignancy in adults and their management poses a significant healthcare problem. Of the various options available, whole brain radiotherapy (WBRT) remains the mainstay of treatment. Nonetheless, there is a need to develop fractionation schedules for best symptom palliation and prolonged survival. This prospective study aims to compare treatment outcome in terms of overall survival in two different WBRT schedules and determine the prognostic factors affecting this outcome.Methods: Sixty previously untreated patients with symptomatic brain metastases were randomized in two arms of 30 patients each to receive WBRT. Arm A patients received 30Gy in 10 fractions (long-course) and arm B received 20Gy in 5 fractions (short-course). All patients were assessed during and after completion of WBRT at 1, 3, 6, 9 and 12 months.Results: At 12 months post WBRT, the objective response rate i.e. complete and partial response (CR+PR) was 6.67% in arm A and 13.34% in arm B (p=0.96). Both WBRT regimens showed similar survival (p=0.65). On multivariate linear regression analysis, age ≤65 years, Karnofsky performance score (KPS) ≥70 and lack of extra-cranial metastases were significantly associated with improved survival at the end of 12 months post WBRT. EORTC QLQ-C30 showed similar improvement in quality of life in both the arms (p=0.86).Conclusions: This study suggests comparable results in the two fractionation schedules. Therefore, short-course WBRT may be used as a more convenient option in favour of shorter hospital stay and lesser burden on RT machines.

An Assessment of Home-Based Newborn Care Plus Innovation in Six districts of Rajasthan: A Cross Sectional Comparative Analysis

Background: To improve coverage of key child health community practices, Home Based Infant Care (HBNC+) was implemented with support of Norway India Partnership Initiative (NIPI) in 4 States of Rajasthan, Madhya Pradesh, Bihar and Odisha. The innovation aimed at improving coverage of key child health interventions through home visits by community health worker, Accredited Social Health Activist (ASHA). Aims & Objective: This paper elucidates the results from the assessment of implementation in intervention versus control districts of Rajasthan. Material & Methods: A cross-sectional intervention-control design with a sample size of 3211 mothers of children in age group 0 to 23 months was adopted. Results: 85 percent of the children (aged 3-23 months) received at least one infant care home visit in the intervention districts in comparison to 32 percent in control. Significant improvements were found in terms of exclusive breastfeeding, weighing and Iron Folic Acid (IFA) consumption and availability of ORS and Iron Syrup in intervention districts. 15 percent additional children had weight plotted in growth charts and 24 percent more consumed IFA syrup bi-weekly in intervention districts. Conclusion: Home visits in infancy is a scalable model and can lead to improvement of community child health practices.