Community perception regarding rabies prevention and stray dog control in urban slums in India.

BACKGROUND: The lack of community awareness about rabies control is a major issue that thwarts efforts to prevent human deaths caused by rabies. The objectives of this study were (1) to assess community knowledge and attitudes about rabies, rabies prevention and stray dog control in an urban slum community and (2) to determine the factors that influence rabies awareness in urban slums. METHODOLOGY: Using a systematic random sampling strategy, 185 participants were selected from 8 urban slums. The data were collected by direct interview using a pre-tested, structured questionnaire. RESULTS: In the study population, 74.1% of the participants had heard about rabies, and 54.1% knew that rabies is a fatal disease. Only 33.5% of the interviewees felt that people in the community had a role to play in controlling the stray dog population. Gender, age and educational status were significantly associated with rabies awareness. CONCLUSIONS: Our study indicates that there are gaps in the knowledge and attitudes of individuals living in urban slums regarding rabies prevention and control. Efforts to promote awareness should be targeted at men, older people and uneducated individuals.

Improving Physician Referral for Tobacco Cessation Clients of Tobacco Cessation Clinic in South India

The major burden of tobacco related diseases is borne by developing countries. Tobacco cessation is an important step in preventing mortality and morbidity due to tobacco related diseases. The objective of the study was to assess the profile of tobacco users utilizing the services of the district anti tobacco cell in Bangalore. A cross sectional study was carried out in 2009. Total of 122 persons above 18 years old, current tobacco users and who were motivated to quit were interviewed by a trained medical social worker. Information about the socio-demographic profile of the clients, details of tobacco use and nicotine dependence levels using Fagerstrom score was collected. SPSS 16.0 software was used for data analysis. The results have been presented using descriptive statistics and ANOVA tests. The study population was comprised of exclusively males. The mean age was 34.9 years. Seventy four percent (73.8%) were smokers while 26% were users of smokeless tobacco products. Fagerstrom scores showed that majority of tobacco users (54% of smokers and 63% of smokeless tobacco users) had moderate to high nicotine dependence. Most of the clients were self-referred. The average pack years of tobacco use and the mean Fagerstrom score were higher in the physician referred group indicating that physicians have access to tobacco users who could benefit the most from tobacco cessation efforts. Clients attending tobacco cessation clinics tend to have moderate to high tobacco dependence. Health care providers need to put in more efforts to refer tobacco users to tobacco cessation services. Improved physician awareness could help in stepping up tobacco cessation efforts.

Community-based needs assessment of leprosy patients in Chamrajanagar district, Karnataka, India.

OBJECTIVES: To assess the medical, disability prevention and rehabilitation and psychosocial needs of leprosy patients. DESIGN: Community-based cross sectional study. RESULTS: 259 registered leprosy-affected people were studied. 26% of subjects had presented by voluntary reporting. The mean detection delay was 8.25 months (SD 6.45). 66.8% of the study subjects had received regular treatment. Knowledge about multi-drug therapy (MDT) was satisfactory in 44.4% whereas knowledge of reactions was highly unsatisfactory. 7.7% had leprosy reactions among which only 25 received medical care. Disability proportion was 20.1% out of which 8.5% had Grade 1 and 11.6% had Grade 2 deformity. All these disabled individuals needed skin care, 44.2% of them needed wound care and 36.5% needed joint care. There was wide discrepancy between need for self care, training received and resources available for practising the same. The extent of dehabilitation was more among subjects with visible deformities. CONCLUSION: Medical needs identified in study subjects include capacity building of patients regarding MDT & reactions, plus awareness generation in general community such that voluntary reporting is enhanced and the detection dela shortened in the district. Strengthening drug inventory and distribution systems fo uninterrupted supply of drugs is essential. There is a need to reorient health care staff regarding leprosy management and DPMR. Rehabilitation needs identified are capacity building with regard to prevention of deformity and supplies (POD tool kit for self care) for the same. It is recommended that the district heath system should conceptualise and implement an evidence-based field level disability care and prevention programme, with community-based rehabilitation approach.

Inhibitory action of the defensive discharge of the grasshopper, Poecilocerus pictus, on certain enzymes in the lizard, Calotes nemoricola.

Administration of the defensive secretion of the grasshopper, Poecilocerus pictus inhibited acetyl-cholinesterase (AChE) and adenosine triphosphatases (ATPases) in the brain and muscle tissues of the garden lizard, Calotes nemoricola. The inhibition was gradual, continuous and irreversible with lethal doses of the defensive secretion, whereas the inhibition observed with sublethal doses was followed by an increase towards control levels within 24 h after injection. In vitro application of defensive secretion also showed concentration-dependent inhibition in the activity of AChE and ATPases in the tissue homogenates. Inhibition in AChE activity might be a factor for the observed mortality is the defensive fluid-treated lizards. Since the cardenolides are known to inhibit the activity of ATPases, the inhibition in the activity of ATPases observed in the present study suggests the presence of cardenolides in the defensive fluid of P. pictus.