Proliferative glomerulonephritis with acute renal failure-a rare manifestation in seronegative rheumatoid arthritis.

A 55 years old lady with advanced rheumatoid arthritis (RA) presented with severe acute renal failure with significant proteinuria preceded by fever for 14 days. She had no history of taking drugs usually responsible for glomerulonephritis, neither had she any clinico-biochemical evidence of peri-infectious glomerulonephritis. Acute interstitial nephritis (AIN) was excluded by absence of eosinophilia and eosinophils in urine. Renal biopsy reveled absence of amyloidosis and showed Focal segmental proliferative glomerulonephritis (FSGN). Patient was successfully managed with methyl-prednisolone followed by steroid and immunosuppressive and patient came over renal failure. So FSGN should be considered as one of the causes of acute renal failure in a patient with seronegative RA which may respond to immune-therapy like rapidly progressive glomerulonephritis.

Eradicating Polio: It's Feasibility in Near Future.

Continuous wild poliovirus transmission despite 12 years of intensive surveillance has raised serious questions about the feasibility of polio eradication programme with current strategy in near future. At present most of the cases are confined to four endemic countries, which are causing sporadic outbreaks in non-endemic areas. India has experienced a significant increase in number of cases reported in 2006 compared to previous year. Outbreaks originated in western UP which was due to the accumulation of susceptibles between the last outbreak in 2002 and early 2006. Substantial improvement has been observed in strategies of polio eradication but still there are gaps in the programme implementation which needs immediate attention so that goal of polio eradication can be achieved at the earliest opportunity. Even though there are many issues but there are also many factors, which favour polio eradication. These factors include new tool in form of m OPV, natural immunity due to recent outbreak, limiting international spread of polio, new researches to guide programme in right direction, political commitments from endemic countries, etc. 2008 presents the best opportunity ever to interrupt wild polio virus transmission which will lead to global eradication of Polio. Since global eradication is within sight, it is scientifically possible to eradicate the disease in near future.

Need of training for health professionals on National Rural Health Mission.

Training plays a key role in health manpower development and management of health care system. Since NRHM is a new concept, due weight-age has to be given to various components of the Mission. For the efficient and effective performance of medical and paramedical workers a certain level of competence in the form of knowledge, skill and attitude are essential. Various aspects of training activities to be included in training programmes have been discussed in the paper.

Distribution of virulence genes in Salmonella serovars isolated from man & animals.

BACKGROUND & OBJECTIVES: Pathogenesis of Salmonellosis depends upon a large number of factors controlled by an array of genes that synergise into the actual virulence of Salmonella. A study was undertaken to observe the distribution of three such genes, namely, Salmonella enterotoxin (stn), Salmonella Enteritidis fimbrial (sef and plasmid encoded fimbrial (pef genes, among different serovars of Salmonella enterica isolated from man and animals. METHODS: A total of 95 isolates belonging to S. Typhimurium (51), S. Enteritidis (36), S. Bareilly (3), and S. Paratyphi B (5) serovars were subjected to polymerase chain reaction (PCR) assay for the detection of stnl ssf and pef genes using their specific primers and the PCR products were analysed by 1 per cent agarose gel electrophoresis for the presence of the respective genes. RESULTS: Varying distribution pattern of these genes was observed amongst the isolates. While, stn was found in all the 95 strains, sef was found only among the S. Enteritidis isolates. The pef gene was found to be absent in 10 isolates including the three S. Bareilly isolates. INTERPRETATION & CONCLUSION: Findings indicated that the stn gene is widely distributed among Salmonella irrespective of the serovars and source of isolation. However, the sef gene appears to be serovar specific. Since the stn gene is found in all the isolates, it can be a viable target gene to explore the possibility of direct detection of Salmonella from samples from biological sources.

Serological study for sexually transmitted diseases in patients attending STD clinics in Calcutta.

Total 457 patients attending different STD clinics of Calcutta were studied for serological tests for STD. TPHA positivity was maximum (18.60%), followed by chlamydia infection (15.97%), VDRL reactivity (8.98%), HIV infection (6.35%), and HBs Ag (3.72%). Total 37.20% samples were positive for one or more infection. Out of these, one, two, three and four tests positivity was seen in 65.29%, 25.88%, 8.24% and 0.59% respectively. The age group which had maximum infection (20.13%) was 15-30 years.

Reproductive and child health programme.

Reproductive and Child Health Programme is an integrated and comprehensive programme based on realistic decentralised area specific microplanning tailored to meet the local needs. There is adequate emphasis on provision of good quality of services under the programme. The present paper traces the genesis and evolution of the RCH programme followed by its objectives, strategies and components. Various mechanisms for the implementation, monitoring and evaluation of the programme are discussed. The programme is analysed critically and suggestions for improvement are provided.

Evaluation of some risk factors for ischaemic heart disease under a matched pairs case-control design.

A pair-wise matched case-control study was carried out in 200 male patients of ischaemic heart disease (IHD). The cases were matched with an equal number of controls in respect of the variables viz., age and socio-economic status. The objective was to quantify the risk of developing IHD for some of the leading risk factors under the univariate and multivariate situations. The analysis revealed that of the factors (smoking, overweight, hypertension, diabetes, serum cholesterol and family history) considered, the smoking habit of the individual, presence of family history of the disease and overweight were the significant risk factors responsible for the development of the disease. The estimated odds ratios were found to be 3.29, 2.60 and 2.00 respectively.

Profile of tuberculosis--an Army experience.

With the advent of HIV infection an increased awareness has arisen on its effect on the incidence of various diseases. In the Indian context an increased incidence of Tuberculosis has been expected. The Army is a controlled relatively healthy constituent of the general population. It hence provides an ideal sample for gauging any dramatic change in incidence. The present paper covers the secular trend of the disease from the days of independence and highlights the differing rates in the stratum of society within the Army. With increased awareness and improvement in diagnostic facilities an increased incidence of the disease has been noticed. However a prospective study to further study various features of the disease as well its correlation if any with HIV is necessary. The paper also touches upon manpower wastage and age profile of Tuberculosis in the Army, which is an important concern to them.

Role of distance learning in health manpower training.

In order to meet the challenges of training of the health workers at various levels, there is a definite requirement of the involvement of various disciplines. Distance education can meet the need for training of the medical and para-medical personnel by utilising a variety of educational technology. Distance education has tremendous potential in training of the medical and para-medical workers in the health sector.

Evaluation of susceptibility status of Culex quinquefasciatus larvae to few organophosphorus insecticides based on logistic regression analysis.

A laboratory trial was carried out at Pune to evaluate the effectiveness of five types of larvicides viz. Malathion, Temephos, Fenthion, Dichlorvos and Fenitrothion against Culex quinquesfasciatus larvae. The expected number of mortality at various dose levels for the five types of insecticides were estimated separately using logistic regression model. Based on the fitted model, the estimated dose level corresponding to the 90 percent mortality (LC90) was obtained for each insecticide. Approximate 95 percent confidence intervals for the LC90 dose, in each case, has been provided. The analysis revealed that out of all the five types of insecticides included in the study, fenthion was the most effective. The estimated value of LC90 in this case was the lowest and is equal to 0.007 mg/L. The effectiveness of temephos, dichlorvos and fenitrothion was found to be approximately same and malathion was the least effective. The results were found to be comparable with that obtained under probit method.

An epidemiological study of hearing loss in a slum in Pune.

A survey of 690 randomly selected person from a urban slum at Pune was conducted to screen hearing loss clinically. Otitis media was found to be the commonest cause for loss of hearing. Control measures were recommended.

An epidemiological study of malaria in a north-Indian district.

A retrospective epidemiological study was carried out in Gurgaon District of Haryana, wherein data on malaria for a period of more than three decades (1958-1989) obtained from various sources were analysed. The study revealed a rise in the incidence of this disease from midsixties onwards and reached peak in 1976. Subsequently, there has been a gradual and sustained decline, possibly due to better implementation of Modified Plant of Operations (M.P.O.) in a more realistic and rational manner. Various malaria-metric indices like A.P.I., A.B.E.R., S.F.R., etc, have been analysed and attempts made to compare these parameters with that of Haryana State as well as with all India average for last few years. The analysis of the cases according to species, age of patients, seasonal incidence and temporal and spatial distribution have also been discussed.

Laboratory evaluation of some larvicidal agents against Anopheles culicifacies in Pune.

A laboratory study to evaluate some larvicidal agents against Anopheles culcifacies was carried out. The findings of this study brought out that the larvae of this species were highly susceptible to temephos, fenthion, Paris green and Mosquito Larvicidal Oil (MLO) in that order. The LC50 values in respect of these larvicides were 0.0009 ppm, 0.0081 ppm, 0.029 ppm and 0.015 ml respectively and LC90 values were 0.0018 ppm, 0.022 ppm, 0.11 ppm and 0.046 ml respectively.

A case control study of cancer cervix patients attending Command Hospital, Pune.

A case control study was undertaken with the objective to determine the association of certain host factors like marital status, age at first marriage, duration of married life, parity, literary status and genital hygiene, in the subsequent development of cancer cervix. A total number of ninety-two cases and an equal number of control subjects, under matched case control design, were studied at Command Hospital, Pune over a period of nine months. Salient findings of this epidemiological study have been highlighted in this communication. Few of the risk factors viz early age at first marriage, longer duration of married life, increased and early parity, low educational status and poor genital hygiene were found to have played significant role in the subsequent development of carcinoma cervix.