Developing Block Wise Composite Health Index in Yavatmal District, Maharashtra State, India: An Analysis of Available Data

Introduction: Numerous health indicators from different domains and comprehensive systems for describing health of community at state or district level are in vogue. Some sub-district information is also available from Health Management Information System but the numbers of indicators are many. Here composite health index of sub-district level is calculated similar to documented procedure. Objective: To develop block wise composite health index in an average district, Yavatmal district using available data. Methods: We grouped health indicators in following four categories; health outcomes, health system, other determinants and utilization of services. From these categories we selected four, three, two and one indicator respectively. Almost all the information is collected from already available data. There are 16 blocks in Yavatmal district. Block wise information of all indicators was first compiled. The block having best value was given 100 marks and remaining blocks were given proportionately less marks. The block wise total marks were calculated. The total score was converted into index by dividing by 1,000. Results: The composite health index ranged from 0.369 to 0.794. The median was 0.425 and interquartile range was 0.126. Out of ten, nine health indicators had normal distribution. We observed positive correlation between urbanization and composite health index. The Yavatmal block obtained highest composite index 0.794 and was an outlier. Principal component analysis extracted four components which contributed 82.06% to total variance. Conclusion: Using only ten indicators and simple method blocks composite health index can be developed which may be used to compare blocks or even districts.

The action of red scorpion (Mesobuthus tamulus coconsis, pocock) venom and its isolated protein fractions on blood sodium levels

Red scorpion (Mesobuthus tamulus or Buthus tamulus) venom samples were collected at different regions of India: western (Chiplun and Ahmednagar from Maharashtra State) and southern (Ratnagiri and Chennai from Tamil Nadu State). The action of whole venoms on the blood sodium levels of mice was assessed using flame photometry. Seven peptides were common to all venom samples. They were separated using the native polyacrylamide gel electrophoresis (PAGE) technique and their activities were also studied using flame photometry. There was a decrease in the concentration of sodium ions in the serum, which suggested the blockage of such ions by scorpion venom toxins. Among the 10 protein bands isolated, the band at 79.6 kDa presented maximum activity in decreasing serum sodium ions concentration. Whole venom from Chiplun region also showed maximum activity. The western blotting technique demonstrated that the anti-scorpion venom sera produced by Haffkine Biopharmaceuticals Corporation Ltd., India, neutralized all four venom samples.(AU)

Isolated breast mucormycosis.

Mucormycosis is unusual in surgical practice. Awareness of the classical findings leads to early detection. Excisional therapy whenever possible along with systemic antifungal treatment is the key to successful outcome. A 70 year old female, a known case of diabetes mellitus and chronic obstructive pulmonary disease, on inhalational steroids and oral hypoglycemic agents, presented to us with complaints of sudden onset pain, redness and swelling of left breast. A diagnosis of severe mastitis was made and a release incision was taken. The entire breast became gangrenous in next 24 hours and simple mastectomy had to be performed as a life saving measure. Histopathology revealed mucormycosis of breast. To the best of our knowledge this is the first reported case of mucormycosis of breast in the English literature.

Primary amebic meningoencephalitis.

This case is reported with the intention of highlighting the presentation of primary amebic meningoencephalitis as acute meningitis, a rare differential diagnosis with presence of free living amoebas in the CSF.

Intraspecific variation in protein pattern of red scorpion (Mesobuthus tamulus, coconsis, pocock) venoms from Western and Southern India

Red scorpions Mesobuthus tamulus (Coconsis, Pocock) were obtained from different regions of West and South India (Ratnagiri, Chiplun and Ahmednagar from Maharashtra and Chennai from Tamil Nadu, respectively). Their venoms composition was analyzed using gel electrophoresis (SDS-PAGE). All venom samples shared six bands of 170, 80, 60, 57, 43, and 38 kDa molecular weights. Bands of 115 kDa and 51.5 kDa were characteristic of venoms obtained from red scorpions of Chiplun region, and the 26kDa band was absent in scorpion venom from Tamil Nadu. The separated protein band patterns suggest that the venoms from Ratnagiri, Ahmednagar and Tamil Nadu had high similarities in their biochemical composition but differed from that of Chiplun region. These data were also supported by the Jaccard (J) index. The J value was 0.33 for venom obtained from Ratnagiri-Ahmednagar, 0.31 for venom from Ratnagiri-Tamil Nadu, and 0.3 for venom from Ratnagiri-Chiplun region. This suggests the existence of genetic variation among the different strains of red scorpion in western and southern India. The antiserum produced by Haffkine Biopharmaceuticals Corporation Ltd. completely neutralized proteins of venoms from all the regions studied.(AU)

Glassy cell carcinoma of the uterine cervix a rare histology. Report of three cases with a review of the literature.

Glassy cell carcinoma is a poorly differentiated variant of adenosquamous carcinoma of the cervix associated with an aggressive course and a poor prognosis. We present three cases of glassy cell carcinoma of the cervix. Patients presented with a cervical growth which was biopsied. Histology the tumours showed nests of cells with a granular or clear cytoplasm, displaying marked pleomorphism and mitoses. Stroma showed an eosinophilic infiltrate. Two tumours showed a pure glassy cell pattern and one showed glandular differentiation with intracellular and extracellular mucin. Patients were treated with a combination of surgery, radiotherapy and chemotherapy but showed a poor response. Two patients died of the disease of pelvic or distant metastases within two years of diagnosis and one was lost to follow up. Although glassy cell carcinoma runs an aggressive clinical course, an early diagnosis may help in a more effective management and offer a better prognosis.

Red cell exchange using cell separator (therapeutic erythrocytapheresis) in two children with acute severe malaria.

Red cell exchange using a cell separator (therapeutic erythrocytapheresis) has been used successfully in a large number of clinical conditions including acute severe cases of malaria. We report two children suffering from severe malaria (Plasmodium falciparum) with infestation rates of 75% and 67% respectively. They were treated successfully with erythrocytapheresis in combination with antimalarial treatment.

Evaluation of efficacy of nizer versus nimesulide tablets in otitis media.

An evaluation of clinical efficacy of nizer versus nimesulide tablets was undertaken in 118 patients suffering from otitis media. Nizer demonstrated rapid and powerful analgesic and antipyretic effects compared to plain nimesulide, without additional side effects.

Rapunzel syndrome with a long tail.

A rare form of gastric trichobezoar extending into small bowel with varying gastrointestinal symptoms is known as Rapunzel syndrome. A case history of 6 years old boy is described. This is the twelfth patient with Rapunzel syndrome in the literature.

Gastric teratoma: a rare cause of gastrointestinal bleeding.

Gastric teratoma is a rare tumor of infancy, almost exclusively found in males. We report a 6-month-old male child with gastric teratoma who presented with gastrointestinal bleeding; he was treated successfully with local excision of the tumor.

Iatrogenic gastric fistula due to inappropriate placement of intercostal drainage tube in a case of traumatic diaphragmatic hernia.

A 26-year-old, 30 weeks primigravida presented with a gastric fistula through a left intercostal drain, which was inserted for drainage of suspected haemopneumothorax following minor trauma. It was confirmed to be a diaphragmatic hernia, with stomach and omentum as its contents. On exploratory laparotomy, disconnection of the tube and fistulous tract, with reduction of herniated contents and primary suturing of stomach was carried out. Diaphragmatic reconstruction with polypropylene mesh was also carried out. Post-operative recovery was uneventful with full lung expansion by 3rd postoperative day. Patient was asymptomatic at follow-up 6 months.