Unanticipated challenges: Institutional anonymity vs child health

The case study presented by the researcher reflects on a dilemma faced during her public health research in a setting in South India. Her case prompts discussions around the public health context, ethical dilemmas therein, research challenges and relevance to other situations in public health research.

Concepts of body constitution in traditional Siddha texts: A literature review

Analysis of body constitution has been in practice in most complementary and alternative systems ofmedicine. Siddha system of medicine practiced in South India consists of fundamental classical literaturethat stress on the importance of tri-humoral makeup of individuals. Guidance has been given in theclassics for identifying specific types of body constitution, various dietary recommendations and diseasesusceptibility. In validating such important traditional fundamental aspects, analytical systematic literature framework is the first robust step. The present study has been conducted to provide an updatedintegrative framework of information about body constitution given in various Siddha literatures inquantitative systematic method by using Whittemore and Knafl's five stage approach. This descriptiveaccount may be useful to construct a suitable questionnaire for Siddha based udaliyal assessment.© 2019 The Authors. Published by Elsevier B.V. on behalf of Institute of Transdisciplinary Health Sciencesand Technology and World Ayurveda Foundation. This is an open access article under the CC BY-NC-NDlicense (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Cholera Outbreak Linked with Lack of Safe Water Supply Following a Tropical Cyclone in Pondicherry, India, 2012.

In the aftermath of a severe cyclonic storm on 7 January 2012, a cluster of acute diarrhoea cases was reported from two localities in Pondicherry, Southern India. We investigated the outbreak to identify causes and recommend control measures. We defined a case as occurrence of diarrhoea of more than three loose stools per day with or without vomiting in a resident of affected areas during 6-18 January 2012. We used active (door-to-door survey) and stimulated passive (healthy facility-based) surveillance to identify cases. We described the outbreak by time, place, and person. We compared the case-patients with up to three controls without any apparent signs and symptoms of diarrhoea and matched for age, gender, and neighbourhood. We calculated matched odds ratio (MOR), 95% confidence intervals (CI), and population attributable fractions (PAF). We collected rectal swabs and water samples for laboratory diagnosis and tested water samples for microbiological quality. We identified 921 cases and one death among 8,367 residents (attack rate: 11%, case-fatality: 0.1%). The attack rate was the highest among persons of 50 years and above (14%) and females (12%). The outbreak started on 6 January and peaked on the 9th and lasted till 14 January. Cases were clustered around two major leakages in water supply system. Nine of the 16 stool samples yielded V. cholerae O1 Ogawa. We identified that consumption of water from the public distribution system (MOR=37, 95% CI 4.9-285, PAF: 97%), drinking unboiled water (MOR=35, 95% CI 4.5-269, PAF: 97%), and a common latrine used by two or more households (MOR=2.7, 95% CI 1.3-5.6) were independently associated with cholera. Epidemiological evidence suggested that this outbreak was due to ingestion of water contaminated by drainage following rains during cyclone. We recommended repair of the water supply lines, cleaning-up of the drains, handwashing, and drinking of boiled water.

Retroperitoneal leiomyosarcoma infiltrating the inferior vena cava (IVC)--a case report.

Retroperitoneal soft tissue sarcomas are difficult to treat because the retroperitoneal organs and great vessels are often involved by the time the patients come to a surgeon. We present the case of a 48 year old woman with a retroperitoneal leiomyosarcoma that had infiltrated the IVC and the renal veins.