Understanding the burden of food allergy among urban and rural school children from north India.

Background: There is paucity of reliable epidemiological data regarding the burden of food allergy in most developing countries, including India. Objective: To provide current estimates of the prevalence and distribution of food allergy among urban and rural school children aged 6-14 years in Delhi and the National Capital Region (NCR) of Khekra in India. Methods: A cross-sectional study was conducted from January 2022 to February 2023 to enroll school children, 6-14 years, from select urban and rural schools in Delhi and NCR. A questionnaire consisting of questions focused on household environment, early life factors, and pediatric food allergy characteristics was administered by a trained medical researcher to collect parent-proxy data. Univariate statistics were used to describe frequencies, percentages, and 95% confidence intervals for survey items. Results: The estimated prevalence of parent-reported food allergy was 0.8% (95% CI: 0.4-1.5; urban: 0.4%, 95% CI: 0.1-1.1; rural: 1.7%, 95% CI: 0.7-3.5). Fruits such as mango (0.3%, 95% CI: 0.1-0.9), strawberry (0.1%, 95% CI: 0.0-0.7), orange (0.1%, 95% CI: 0.0-0.7), and custard apple (0.1%, 95% CI: 0.0-0.7) were reported only by urban children, while rural children reported yogurt (0.6%, 95% CI: 0.1-1.8) and wheat (0.3%, 95% CI: 0.0-1.3). Both groups reported brinjal (also known as eggplant) and banana, 0.1% (95% CI: 0.0-0.7) of urban and 0.3% (95% CI: 0.0-1.3) of rural, respectively. Overall, commonly reported clinical symptoms were diarrhea and/or vomiting (100%, 95% CI: 76.2-100), abdominal pain (88.9%, 95% CI: 58.6-98.8), and rash/itchy skin (66.7%, 95% CI: 34.8-89.6). Among children with parent reported food allergy, 66.7% (95% CI: 34.8-89.6) of food allergies were physician diagnosed, of which 33.3% were diagnosed via history alone (95% CI:7.7-71.4) while 66.7% (95% CI: 28.6-92.3) were confirmed via skin prick test and/or blood test. Conclusion: The overall prevalence of food allergy is very low in Delhi and Khekra, India. Future work should focus on elucidating the complex interplay of early-life, environmental, genetic, and lifestyle factors to understand the reasons for India's low food allergy burden and improve epidemiological clues to prevention for the nations with higher disease burden.

Role of Prescription Practice in Ensuring Patient Safety in the Primary Health-Care Settings in India.

"Completeness (a measure of adequacy)" and the "appropriateness (a measure of the quality of care)" are two dimensions of good prescription practice. The study assessed the prescription practices at the primary health centers (PHCs); to demonstrate the effect of individual and system-level factors, on adequacy and appropriateness of prescription practices, with special reference to e-prescription over manual prescription given the rising acceptance of teleconsultation in health care. A total of 600 manual and 1000 e-prescriptions were randomized using a probability-proportional-to-size sampling method to distribute/allocate samples across manual and e-prescriptions. Findings revealed that while adequacy and appropriateness of prescriptions depend on individual training and clinical practice; adequacy of prescription, especially the manual was compromised by systemic factors, such as nonavailability of space in a prescription, forcing doctors to prioritize documentation of diagnosis, advising tests, and prescribing medicines, over other details (chief complaints and examination findings).

Resetting outcome targets of community surgery camps: The case of the Chhattisgarh tragedy.

State-driven community surgery camps have been organised in India for nearly five decades. Despite their being extremely beneficial to people not having ready access to surgical healthcare (SHC), they continue to be mired in controversies because of negative consequences following free surgery, eg blindness following cataract surgery; infection/death following tubectomy/vasectomy. While the onus of complications during and following surgery camps is commonly ascribed to deficient camp infrastructure/facilities; the contribution of the tendency to achieve high-frequency targets, ie to-do-more-surgery-in-less-time to the problem; continues to escape public scrutiny. Ironically, even the significant and multiple morbid events during surgery camps only evoke a transient public outcry, reflective professional criticism, hyper-media whimpers, and legal turbulence; before fading completely from public memory. This viewpoint piece, by taking into consideration the various ethical burdens that assail community surgery camps (13 deaths in the Chhattisgarh tragedy of 2014, as a case in point); aims to deconstruct inadequate SHC systems and conflicted surgery targets seeking promotion and fame. It also suggests remedial measures to address the problems, especially in terms of identifying a valid end-point for successful surgery, ie surgery completion or surgery outcome; and how the media, polity, professional fraternity, and executives could reorient themselves to respond more sensitively to problems, for the benefit of the patients and community at large. Keywords: community, surgical camps, system, surgery, reporting, mishaps.

The National Rural Health Mission in India: its impact on maternal, neonatal, and infant mortality.

The National Rural Health Mission (NRHM) has been a watershed in the history of India's health sector. As a previously unattempted investment, governance, and mobilization effort, the NRHM succeeded in injecting new energy into India's public health system. A huge expansion of infrastructure and human resources is the hallmark of the NRHM action. Demand-side initiatives led to enhanced utilization of public health facilities, especially for facility births. The impact is visible. The Mission has brought Millennium Development Goals 4 and 5 within India's grasp. Acceleration in infant and neonatal mortality reduction is especially notable. The NRHM has created conditions for the country to move toward universal health coverage.

The study of bacterial flora of different types in hospital waste: evaluation of waste treatment at Aiims Hospital, New Delhi.

Bio-medical waste management rules were formulated in response to the worldwide public concern over medical waste. The practice of separation into different types of waste in health care institutes should be evaluated more scientifically. Due to a lack of data from the Indian sub-continent, this study was initiated at a tertiary care hospital. Samples were collected from different types of waste at the hospital, at different time intervals, for microbiological evaluation. The results reveal that the microbial flora isolated from infectious waste and general waste from the hospital are similar. The samples from general waste in this study reveal many types of pathogens. The bacteria present in the waste initially was low in quantity, but they replicated rapidly over time so that significant numbers were detected by 24 hours, due to environmental factors which were favorable for growth during this period. This study strongly suggests that waste should be removed from the hospital within 24 hours of its generation to prevent environmental contamination caused by any accidental spillage of waste. General waste generated in the hospital should be treated similar to infectious waste, as it can be equally hazardous.

Role of nursing in modern blood banking [in a tertiary level hospital].

With the emergence of Transfusion Medicine Department the definition of Blood Bank has changed. Today, it is not just a bank to collect & issue blood, it prepares and supplies individual blood component, to the patients as and when the need arises during the course of treatment. The planning & management of any blood bank depends on number of functions it is required to serve and the number of units of demand of blood & blood products. This has also changed the role of nursing from skilled nursing care to managing the blood bank services. Hence, there is a need for the nursing personnel to know about the recent advances in planning and management of transfusion medicine, so that they can handle this dual responsibility as a Nurse and a manager.