Social acceptance and job satisfaction of ASHA workers in the Garo Hills Division of Meghalaya: a cross-sectional study

Background: ASHAs were appointed by NRHM to provide preventive, promotive and curative healthcare services in the rural including tribal villages in Meghalaya. However, their social acceptance and job satisfaction remain less studied. Hence our study aimed at it.Methods: A cross-sectional study was conducted among 140 ASHAs from randomly sampled 142 villages across 15 PHCs in five districts. To collect data, we used a semi-structured back-translated and validated questionnaire consisting socio-demographic profile of ASHAs, level of perceived social acceptance and job satisfaction. Data were analysed using SPSS version 22.0.Results: Mean and median age of ASHAs were 33.29 and 32.00 years respectively. Over 63% belonged to Garo tribes, 67% studied high school, and 91% married. Village elders selected 76% of ASHAs, and 81% were as ASHAs for at least eight years. About 86% were trained in a minimum of three modules and all found their training effective. While 92% had the medical kit always filled, 100% had registers updated, and 94.3% facilitated VHND and FHD meetings. About 97% accompanied the pregnant women, 96.4% attended PHC meetings regularly and 83.6% organized VHSNC meeting. Though 93.5% reported a high acceptance of ASHAs' services, social acceptance of ASHAs was rather to some extent for 36.4%. Almost 52% of ASHAs were dissatisfied with job and 61% were unhappy with their performance-based remuneration.Conclusions: Community must be aware of ASHAs’ role, and their job satisfaction has to be increased with a corresponding increase in incentives while developing strategies to ease the process of payments.

Production of actinomycin-D by the mutant of a new isolate of Streptomyces sindenensis / Produção de actinomicina-D por um mutante de uma nova cepa de Streptomyces sindenensis

An actinomycin-D producing strain was isolated from soil and characterized as Streptomyces sindenensis. The culture was subjected to UV irradiation and a mutant with 400 percent higher actinomycin-D production was isolated (400 mg/l-1 as compared to 80 mg/l-1 produced by the parent). Production medium was optimized and antibiotic yield with the mutant was enhanced to 850 mg/l-1 which is 963 percent higher as compared with the parent.

Uma cepa produtora de actinomicina-D foi isolada de solo e caracterizada como Streptomyces sindenensis. A cultura foi submetida à radiação UV, e um mutante capaz de produzir 400 por cento mais actinomicina-D foi isolado (400mg/L comparado a 80mg/L produzido pela cepa parental). O meio de produção do antibiótico foi otimizado e o rendimento aumentou para 850 mg/L, ou seja, 963 por cento mais alto que a cepa parental.

Interpretation of treadmill stress test in patients with coronary artery disease receiving beta blocker therapy.

Graded maximal treadmill exercise responses were studied before and after beta blockade (atenolol 100 mg once daily for 2 weeks) in 20 male patients with chronic stable angina. Beta-blocking effect consisted of significant reduction of resting heart rate (HR) by 21%, systolic blood pressure (SBP) by 12% and rate pressure product (RPP) by 30%. While the maximum exercise capacity was marginally increased by mean 1.7 min +/- 1.6 SD (P less than 0.001) under the influence of therapy, peak HR, SBP and maximum RPP were significantly lower (P less than 0.001) than in preatenolol exercise tests. Similarly, while the configuration and magnitude of ST segment depression did not differ materially between the pre and post atenolol tests, onset time of ST change was delayed and offset time shortened significantly. These parameters cannot be relied upon to assess the extent and severity of coronary artery disease (CAD) if stress test is carried out while the patient is on a beta-blocking drug. The overall sensitivity of the stress test to detect coronary disease is, however, not likely to be compromised because of negligible influence of beta-blockers upon ST segment depression provided maximally tolerated (not submaximal) exercise is performed. ST/HR slope, an exercise test variable known to correlate well with the extent of CAD, was shown to be uninfluenced by beta-blockade. Its measurement is therefore recommended in interpreting stress tests performed in patients receiving beta-blocker therapy. This, however, requires a meticulously prepared protocol of recording computer averaged QRST complexes and multilead ECG tracings at very frequent intervals throughout the exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative efficacy of atenolol and labetalol in essential hypertension--a double blind cross over trial.

In a double blind cross-over drug trial, antihypertensive effects (resting and after dynamic exercise) of atenolol and of labetalol were studied in 20 patients of mild to moderate essential hypertension. Both drugs exhibited almost equal antihypertensive response, and were well tolerated. Haemodynamic variables (HR, SBP, DBP and RPP), both at rest and after maximal tread mill exercise, were significantly altered (P less than 0.001) by both drugs. Exercise capacity was observed to be marginally improved by atenolol. Although the antihypertensive effect, when compared between the two drugs, was not statistically significant, individual suitability or comparison revealed a preference for atenolol in 17 patients and for labetalol in 3 patients.

Peak expiratory flow rate and its prediction formulae in Haryanvis.

Peak expiratory flow rate (PEFR) was studied in 806 healthy 6 to 58 year old Haryanvi males. A steep rise in PEFR is seen with age up to 18 years, little variation occurs between 19 to 26 years and is followed by a gradual fall thereafter. The formulae for the prediction of PEFR from age and height in different age groups have been worked out. Haryanvi children are taller having PEFR and predicted values of PEFR higher than the children of other Indian states and are well comparable to Western children. On the other hand in Haryanvi adults observed and predicted values of PEFR are low. It is possible that economical uplift of this area due to industrialization and green revolution has led to improved nutrition resulting into better physical and functional (PEFR) development of younger generation. It is suggested that in developing states the physical and functional norms should be periodically reviewed.

Pulmonary functions and their correlation with anthropomorphic parameters in young adults of Haryana (India).

Pulmonary functions in 169 young males of Haryana were studied with the help of a water seal spirometer and Wright's peak flow meter. Different parameters analysed were FVC, FEV1%, P.F.R., MVV, and expiratory flow rates between 25-50%, 25-75% and 50-75% of FVC. Our mean values are well comparable with those of Indian workers but less than those reported by Western workers. Pulmonary functions correlate better with physical parameters, height arm span and upper segment than with age. Correlation coefficient (r) values of FVC and anthropomorphic parameters are +0.7953, +0.3835, +0.3566 and +0.0992 with arm span, upper segment, height and age respectively. These values of pulmonary functions in healthy adults when compared with those obtained from patients suffering from chronic obstructive lung disease, it was observed that expiratory flow rates may be more useful in the detection of pulmonary changes in obstructive lung diseases at an early and reversible stage.