Health and Social Security Needs of Rickshaw Pullers in Ranchi.

A significant number of "marginalized" population groups are denied their health rights, healthcare access, benefits of government health programs, and other health-related social security benefits. These population groups, particularly the rickshaw pullers of India, are vulnerable because of their poor social and economic status, migration history, lack of permanent settlements, lack of social capital, and so on. These reasons, coupled with other social-political reasons, lead to no or limited access to health services and poor health conditions. This study intends to explore and understand the context and health seeking behavior of rickshaw pullers in Ranchi, the capital city of Jharkhand state in India, with special reference to wider social determinants of health such as, access, affordability, and delivery of health services. The data was collected from 1,000 rickshaw pullers from 40 "rickshaw garages" in Ranchi. The findings of the study show that rickshaw pullers can't afford to "attach" much importance to their health due to various reasons and suffer from a variety of occupational and other illnesses. The health conditions of the rickshaw pullers are affected by poverty, negligence, illiteracy, lack of awareness and unavailability of affordable, quality health services. These are only a symptom of the larger structural issues affecting health. The study suggests that rickshaw pullers, being a marginalized and excluded population group, require special health and social security programs that include safe, affordable, and accessible services along with a special focus on health education, behavior change, and promotion of appropriate health-seeking behavior.

Food and Drug Administration approval process for ophthalmic drugs in the US.

PURPOSE OF REVIEW: The purpose of this review is to provide the overall framework of the review and approval of ophthalmic drugs in the US. RECENT FINDINGS: Examples from the recent approval of the ranibizumab injection (Lucentis; Genentech, South San Francisco, California, USA) are offered to illustrate the current approval process at the Food and Drug Administration (FDA). SUMMARY: New drugs are brought to the US market after review of the New Drug Application or Biologic License Application by the FDA. This review process requires the teamwork of an interdisciplinary team of clinicians, scientists and regulatory personnel. This team is ultimately responsible for recommending to the Secretary of Health and Human Services (or designee) the approvability of a drug based on defined requirements including the drug's risk/benefit profile, quality and purity, and the drug's ability to be labeled effectively. Within the Center for Drug Evaluation and Research this review team for ophthalmic drugs resides primarily within the Division of Anti-Infective and Ophthalmology Products.

Identification and quantification of thymosin beta4 in human saliva and tears.

Thymosin beta(4) (Tbeta(4)) is a ubiquitous, naturally occurring, 43-amino acid peptide that takes part in several biological activities including angiogenesis, inhibition of inflammation, wound healing, chemotaxis, and endothelial cell migration. Recent studies also indicate that Tbeta(4) accelerates corneal wound healing and downregulates several proinflamatory chemokines and cytokines. In this study, we sought to determine whether Tbeta(4) is naturally occurring in human tears and other human bodily fluids, such as saliva. Tear and saliva samples were analyzed by EIA to identify and quantify the amount of Tbeta(4) present. Around 10-20 samples were collected from each of three different age groups: 15-20, 25-35, and >50 years old with n = 30 and n = 60 for tears and saliva, respectively. Exclusion criteria included the use of any topical ophthalmic or topical oral medication and/or history of ocular or oral surgery within the past 6 months. Tears were collected from both eyes using Schirmer's strips. Saliva samples were collected in sterile tubes and were then centrifuged to remove solid particles. Tbeta(4) was found in tear and saliva samples in all age groups. The concentrations ranged from 0.5-7 mug/mL in tears and 0.2-3.6 mug/mL in saliva. In both fluids, Tbeta(4) concentration varied with age and appeared to peak at ages 25-35 years. Studies are in progress to determine if Tbeta(4) levels in saliva and tears demonstrate a circadian rhythm during a 24-h period, as well as to confirm that they vary with age and to explore if they vary with diseased states. This is the first study to report the presence of Tbeta(4) in human tears and saliva. This finding raises the possibility that Tbeta(4) acts as an endogenous agent contributing to the rapid healing of corneal and oral wounds. Considering that Tbeta(4) facilitates reepithelialization and modulates anti-inflammatory mediators, Tbeta(4) could potentially be used therapeutically in the treatment of (a) ocular surface disease and injury of eye and (b) various oral disorders, such as periodontal disease.

Ethnic differences in glaucoma: prevalence, management, and outcome.

PURPOSE OF REVIEW: Glaucoma has a disproportionate prevalence among specific ethnic groups. Therefore, the issue of 'race' and glaucoma has been the focus of much discussion. The purpose of this article is to provide a review of the literature regarding the prevalence, management, and outcome of glaucoma among different ethnic populations. RECENT FINDINGS: This review highlights not only recent reports but also notes key studies from the past regarding glaucoma and ethnicity. Given the variation in presentation and the response to therapy, it is important to individualize one's therapeutic approach in any given patient. SUMMARY: Our knowledge regarding glaucoma and ethnicity helps us to customize a patient's therapeutic regimen more effectively. Therefore, understanding an individual's heredity and culture is essential to properly identify, treat, and manage individuals at risk and existing patients with glaucoma.