Awareness of tuberculosis in the community: time to rethink strategies

Background: Tuberculosis is highly prevalent in developing countries like India and several strategies have been implemented by the World Health Organization and Government of India in order to minimize its burden. However, effectiveness of these strategies is best achieved when there is adequate awareness among the general population regarding the cause and spread of the disease. This study was carried out to evaluate the knowledge, attitude and practices regarding tuberculosis among general population.Methods: This cross sectional study was carried out among 500 adults visiting our tertiary care center as patients or attenders for a period of one year between April 2018 and March 2019. A structured interview schedule was used to collect information regarding the knowledge, attitude and practices regarding the cause, spread and management of tuberculosis infection.Results: About 73.6% of the study participants felt that tuberculosis was a genetic disorder, while only 12.4% of them were aware that the infection was transmitted through coughing, etc. Moreover, 18% of the participants believed that the medications for treating tuberculosis could be stopped without the supervision of the health care provider.Conclusions: This study has elicited the prevailing misconception regarding the cause, transmission, treatment and prevention of tuberculosis. It is important for policy makers and public health program implementation experts to develop health literacy campaigns to specifically create awareness among the population, so as to facilitate successful mitigation of the disease.

Study of Normoalbuminuric Diabetic Nephropathy in Type 1 Diabetics

Introduction: Diabetic kidney disease (DKD) is one of the primary causes of end-stage renal disease. Early diagnosis is veryimportant in preventing the development of DKD. Urinary albumin excretion rate and glomerular filtration rate (GFR) are widelyaccepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the firstclinical sign of DKD.Aim: The aim of the study was to study the existence of normoalbuminuric diabetic nephropathy in type 1 diabeticsMaterials and Methods: This prospective study was conducted in type 1 diabetic by documenting low c-peptide level. Fastinglipid profile was done in these patients. Serum electrolytes such as potassium, sodium, magnesium, and uric acid were measured.The characteristic profile of patients with duration of diabetes and low GFR was analyzed with respect to the duration of diabetes,serum magnesium level, hypertension, retinopathy, and renal biopsy features.Results: In 95 patients, of 17 patients with renal biopsy-proven normoalbuminuric diabetic nephropathy, 11 patients (65%) hadserum magnesium of <2 mg/dl, and only six patients had serum magnesium of >2 mg/dl. Among the 17 patients, five patients(29%) had hypertension and eight patients (47%) had diabetic retinopathy changes.Conclusion: There exists an entity – normoalbuminuric diabetic nephropathy in type 1 diabetic patients. The incidence ofnormoalbuminuric diabetic nephropathy increases with duration of diabetes.

2D linear array device as a quality assurance tool in brachytherapy applications

Background: External beam radiotherapy and brachytherapy plays a vital role in the management of cancer cervix. High dose rate brachytherapy is being presently used worldwide for the brachytherapy applications. At present, 2-Dimensional linear array detectors are the most common QA tool used for pretreatment patient specific quality assurance in external beam radiotherapy alone and till date no dedicated brachytherapy tool is available. An attempt has been made to explore the feasibility of using 2 dimensional linear array, Imatrixx as a QA tool for brachytherapy

Materials and Methods: Reference treatment plans are generated by Plato treatment planning system using the images of Imatrix acquired with Siemens CT simulator. The efficacy of Imatrixx as a QA tool for intracavitary treatment plan verification, dwell position and dwell time accuracy verification are studied

Results: The length and the widths along with the area of the reference isodose curves of the intracavitary treatment plans generated by Plato Planning system and measured with Imatrixx is compared. The difference in area of the reference isodose curve is found to vary from -0.59 cm2 to 4.59 cm[2]. The estimated user correction factor for lridium-192 energy, 0.38 MeV is 1.090 with a standard deviation of +/-0.0211. Machine related QA such as dwell position and dwell time were measured with Imatrixx with an accuracy of 0.5 mm and 0.02 s respectively

Conclusion: Results shows that the 2-Dimensional linear array, Imatrixx can be used with accepted accuracy for both machine and patient specific quality assurance in brachytherapy treatments?