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Enteric fever is a common but serious disease that affects mostly children and adolescents in the developing countries. Salmonella enterica serovar Typhi remains responsible for most of the disease episodes; however, S. Paratyphi A has also been reported as an emerging infectious agent of concern. The control measures for the disease must encompass early diagnosis, surveillance and vaccine to protect against the disease. Sanitation and hygiene play a major role in reducing the burden of enteric diseases as well. The current status of diagnostics, the surveillance practices in the recent past and the vaccine development efforts have been taken into account for suggesting effective prevention and control measures. However, the challenges in all these aspects persist and cause hindrance in the implementation of the available tools. Hence, an integrative approach and a comprehensive policy framework are required to be in place for the prevention, control and elimination of typhoid fevers.
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Objective: To review the Mid-upper arm circumference (MUAC) cut-off currently being usedto identify Severe Acute Malnutrition (SAM) as currently defined using Weight-for-Height.Methods: Cross-sectional study conducted in 24 villages of a Primary Health Centre inWardha district of Maharashtra among 2650 children between the ages of 6 to 59 months.Results: For identifying SAM, sensitivity of MUAC was 23.5% and specificity was 99.7% forcut-off <11.5 cm. Using Youden index, best Mid-upper arm circumference cut-off point toidentify SAM was <13 cm with sensitivity of 74.5% and specificity of 92.7%. Using Receiveroperating characteristics curve, best MUAC cut-off point was 12.8 cm with 74.5%sensitivity and 92.7% specificity. Area under curve was 0.88 (95%CI: 0.85-0.91).Conclusion:The current MUAC cut-off of <11.5 cm for detecting SAM needs to beincreased to ensure that children, who need referral for management of malnutrition, are notmissed.
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Background & objectives: Some studies have systematically assessed the effects of spiritual practice (SP) on the brain using combined neuropsychological testing and functional imaging. The objective of the present study was to compare imaging and neuropsychological changes in healthy individuals after SP and those with only physical exercise. Methods: Healthy adult male volunteers, aged 25-45 yr were randomized into two groups. Group 1 (SP group) underwent the SP and group 2 (controls) did brisk walk for 30 min daily. Detailed neuropsychological evaluation, resting-state functional magnetic resonance imaging (fMRI) and brain 99mTc ethyl cysteinate dimer single-photon emission computed tomography (SPECT) were carried out for both groups before and three months after intervention. Results: Post-intervention, resting state fMRI showed increased connections of left precuneus (in the posterior cingulate cortex area of default mode network) in group 1 and increased left frontal connections in group 2. The neuropsychological tests showed significant improvement in 'Speed of Processing' (Digit Symbol Test) in group 1 and in Focused Attention (Trail Making A) in group 2. The SPECT data in group 1 showed significant improvement in perfusion of the frontal areas, with relatively lesser improvement in parietal areas. Group 2 showed significant improvement in perfusion predominantly in parietal areas, as compared to frontal areas. In addition, significantly improved mood was reported by group 1 and not by group 2. Interpretation & conclusions: This pilot study shows important functional imaging and neuropsychological changes in the brain with SP.
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Background: The phenomenon of population ageing is inevitable. United Nations has defined Population 'ageing or graying nation' where 7% of total population is over 60 years of age. India already has crossed the bar with 8% population above 60 years of age as per census 2011. To address ever growing needs of geriatric population, the first step is to identify and assess those needs. Present study is conducted with objective to assess the health, psychosocial and financial needs of geriatric population in rural Wardha. Methods: This is a community based cross sectional study using mix methods. The Present mix method study had two components - a. Quantitative component: comprising of details on socio-demography, psychosocial needs and financial dependency measured in all 60 participants using predesigned questionnaire and b. Qualitative component: comprises of 10 In Depth Interviews (2 IDI per ward) of elderly participants in community and 5 exit interviews of elderly participants those availed services at PHC. Content analysis of qualitative data was done manually while quantitative data is reported using frequency and percentages. Results: PHC was the first point of contact for 65% of elderly, but most of them were not satisfied with the services and the reason for dissatisfaction was long queue for OPD registration, long waiting period, no sitting arrangement while waiting, frequent non- availability of medicine. Irregular availability of medicine was reported as reason for skipping medicines and out of pocket expenditure. Financial dependency on children limits elderly in healthcare decision making. The recreational activities were limited to taking care of their grand-children, watching TV, and engaging in household activities. Conclusions: Elderly have very basic needs that can be addressed in present setting like a separate queue for registration, adequate sitting arrangement in waiting area, regular availability of medicines. Complete Healthcare insurance of elderly may be a solution to prevent out of pocket expenses.