Effect of Integrated People-Centred Eye Care (IPEC) Model on Eye Care Seeking Behaviour of Community

Background: World report on vision makes integrated people-centered eye care as care model of choice. Integrating eye care with the existing public health system makes services available, accessible, affordable, and sustainable. Being from the community, Accredited Social Health Activists(ASHAs) are better suited to improve people’s eye health-seeking behavior. Objectives: This study aims to assess the eye care-seeking behavior of community and to understand their response toward the approach of integrated vision centers (VC) with ASHA involvement. Methods: A cross-sectional descriptive study was conducted in South Delhi district where integrated VC were functional for more than a year. These centers were supervised by medical officer in?charge, under whom ophthalmic assistants, ASHAs, auxiliary nurse midwives, and pharmacist work. ASHAs were trained in community-based primary eye care. The community survey was conducted on eye health-seeking behavior and utilization of VC services. Descriptive statistics were used for data analysis. Results: Out of 1571 study participants, 998 reported any ophthalmic illness in family in the past 6 months as against 1302 who reported nonophthalmic illness in family. The majority (1461, 90%) were aware about integrated VC and half of them (748, 51.2%) visited it. Of them, 64.2% were motivated through ASHAs. ASHAs spread awareness about eye diseases, eye treatment facility, and referred patients from the community. The majority (93%) were happy with the integrated VC and 87.8% were happy with ASHAs. Conclusion: Integrated VC with ASHA engagement could pave the way for universal eye health. Understanding people’s needs and engaging community would increase the demand for eye care.

A study to assess the knowledge and skills of Accredited Social Health Activists and its retention after training in community-based primary eye care

Purpose: Community volunteers like Accredited Social Health Activists (ASHAs) could be utilized for linking community and eye care services. Research is needed to effectively utilize them. This study was to assess whether ASHAs could imbibe new knowledge in eye care and conduct vision screening. Methods: Settings and Design: A pre?post?intervention study in South Delhi Integrated Vision Centres. It was conducted from January 2016 to March 2017. One day of conceptual training followed by hands?on training in vision screening was imparted to ASHAs. The knowledge was assessed thrice: before, immediately after, and following 1 year after training. The vision screening skill was assessed twice. Descriptive analysis using percentages, mean and standard deviations. Paired t?test was used for assessing the change in scores. Results: A total of 102 ASHAs were recruited. A significant increase in the knowledge score of ASHAs before (14.96) and after training (25.38) (P < 0.001) was noted. The knowledge score was sustained at 1 year (21.75). The satisfactory skill of vision screening was seen in 88 (86.3%) ASHAs after training, while 79 (77.5%) ASHAs still retained it after 1 year. Conclusion: The potential to involve ASHAs in community?based frontline eye care activities: awareness generation of eye diseases, identification of referrable conditions, and facilitating individuals to seek eye care facilities. This study informs about the duration, frequency, and content of the training. It also provides evidence on the improvement and sustainability of eye care knowledge and skills by ASHAs after conceptual and hands?on training

Perception of sex workers of Lucknow City, Uttar Pradesh, India towards sexually transmitted infections.

The prevention, control, and management of sexually transmitted infections/reproductive tract infection (STI/RTI) are well-recognized cost-effective strategies for controlling the spread of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). A cross-sectional descriptive study was done over a period of 1 year to assess the prevalence of STI, knowledge level about STI, and the STI-HIV link among the female sex workers (FSWs) of Lucknow city, Uttar Pradesh, India along with their biosocial characteristics. Most of the FSWs were illiterate, married, Hindus, and belonged to general category. The prevalence rates of STI among street-based and home-based FSWs were 50.6% and 29.8%, respectively. Knowledge about the role of condom in prevention of STI and the STI-HIV link was significantly less among home-based FSWs than those who are street-based. There is a great lack in the awareness among FSWs regarding STI and their prevention. Behavior change communication (BCC) and advocacy strategy were developed, especially for the home-based group, to strengthen their knowledge regarding the STI-HIV link.

Quality of Services in a Tertiary Care Hospital of Northern India: Geriatric Patient Perspective.

This study was planned with the objectives of studying the bio-social and morbidity pattern of elderly and to assess the quality of medical and non-medical services as perceived by elderly patients along with the health worker-patient relation.A Cross-Sectional Descriptive Study was conducted on elderly patients (>60 years) attending outpatient department of a tertiary hospital and residing in Lucknow. Total 242 subjects were selected from the entry gate of outpatient department. Most common morbidity in this age group is hypertension and eye related morbidity in urban area, while in rural area it was musculoskeletal and eye related morbidity. Elderly from Non Peri-urban area mostly perceived that the services rendered were average while majority of those living in Peri-urban area (51.5%) opined that the services rendered were good. Nearly half (44%) of urban elderly patients rated quality of services as average. While among rural elderly patients 42.6% rated quality of services as poor. However those from peri-urban area, 57.1% rated it as poor. Relation of quality of services of hospital with residence of elderly patients was statistically significant (p <0.05).Among elderly of urban area, most frequent morbidity was hypertension. total elderly patient from urban area one third perceived poor quality of services. While elderly patient of rural areas, majority had felt poor quality of service. About 57.1 percent of elderly patient of non peri-urban area had perceived poor quality of service followed by 28.6 percent of very poor quality of services. While of peri-urban area 40.9 percent had felt average quality of services followed by 34.8 percent with poor quality of services.

N-acetyltransferase and cytochrome P450 2E1 gene polymorphisms and susceptibility to antituberculosis drug hepatotoxicity in an Indian population.

Background. Antituberculosis drug hepatotoxicity (ATDH) is common in India. Isoniazid, a constituent of most antituberculosis drug regimens, is metabolized by N-acetyltransferase (NAT2) and cytochrome P450 2E1 (CYP2E1) enzymes. We therefore studied the association of some single-nucleotide polymorphisms (SNPs) in these enzyme genes with ATDH. Methods. Allelic and genotypic frequencies at three SNP loci in the NAT2 gene (rs1799929, rs1799930 and rs1799931) and one locus (rs2031920) in the CYP2E1 gene were studied using restriction fragment length polymorphism in 33 patients who developed ATDH following an isoniazidcontaining antituberculosis drug regimen and 173 healthy blood donors. After confirming adherence of the control data to the Hardy–Weinberg equilibrium model, genotype and allele frequencies in the two groups were compared. Results. For SNP rs1799930 in the NAT2 gene, 7 (21%), 21 (64%) and 5 (15%) patients, and 93 (54%), 62 (36%) and 18 (10%) controls had GG, GA and AA genotypes, respectively (p=0.003; odds ratio [OR] for GA v. GG=4.50 [95% CI 1.80–11.22] and for AA v. GG=3.69 [1.05–12.93]). Allele frequency for G nucleotides for this SNP was 0.53 among patients and 0.72 among controls (OR 2.24 [1.31–3.84], p=0.007). The allele and genotype frequencies of the other NAT2 SNPs and the CYP2E1 SNP showed no significant difference between cases and controls. All the 33 patients and 151 (87%) of 173 controls had mutant allele at one or more of the three NAT2 SNP loci (p=0.03). The presence of two or more mutant alleles, a marker of slow acetylator status, was more frequent in patients (23/33 [70%]) than in controls (73/173 [42%]; OR 3.23 [95% CI 1.45–7.19], p=0.004). Conclusion. In India, the risk of ATDH is increased in persons with ‘A’ allele at SNP rs1799930 in the NAT2 gene, but is not associated with rs2031920 polymorphism in the CYP2E1 gene.

"Effect of short-term cigarette smoking on insulin resistance and lipid profile in asymptomatic adults".

Present study examined the effect of short-term cigarette smoking on insulin resistance and lipid profile in asymptomatic healthy adults. This case control study comprised of 44 healthy male subjects in the age group of 18-40 yrs having BMI 25+3 and WHR < 1.0. Of these 22 smokers were included in the study group and 22 non-smokers in the control group. Subject selection was done such that one smoker and one non-smoker sibling or first degree male relative were selected from the same family. We compared fasting plasma glucose, insulin, lipid profile, and homeostatic model assessment index (HOMA Index) as a measure of insulin resistance between both the groups. Our observation showed that significantly higher values of serum glucose (133.36 +/- 23.45 mg/dl; P < 0.001), serum insulin (32.04 +/- 6.0 2 microU/ml; P < 0.001) and HOMA index (3.62 +/- 0.21; P < 0.001) were found in smokers as compared to non-smokers (serum glucose 86.95 +/- 19.32 mg/dl, insulin 20.09 +/- 4.8 microU/ml, HOMA index 3.29 +/- 0.30). No significant difference was observed for number of subjects having insulin resistance (HI > 3.8) and lipid profile in both the groups. Thus it appears that smokers are prone to develop hyperinsulenemia, hyperglycemia and the metabolic syndrome.