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AIM: To empower and bring the underprivileged senior citizens in the rural areas to the mainstream of life through setting up of model "senior citizens' recreation centers" that can be replicated in the other parts of the country. MATERIALS AND METHODS: Six senior citizens' recreation centers are run in six villages under a community health program of a leading Medical College in South India, which were started by looking into their perceived needs and in a location where organized self-help women groups (SHGs) showed willingness to take the role of caretakers. Together there are 140 members in 6 centers and the most deserving members were identified using a participatory rural appraisal (PRA) method. These centers are open for 5 days a week and the main attraction of the center has been provision of one good, wholesome, noon-meal a day, apart from several recreational activities. The members were also assessed for chronic energy deficiency (CED) and quality of life at the beginning of enrolment using body mass index (BMI) and WHO-BREF scale. RESULTS: The attendance to these centers was nearly 90% of the enrolled beneficiaries. A statistically significant improvement was noticed in quality of life in the physical, psychological, social, and environmental domain (P < 0.05). There was also a significant increase in the average BMI after 1 year of the intervention (P < 0.05). CONCLUSION: Care of underprivileged senior citizens is a growing need in the rural areas and the "Recreation centers" proved to be a beneficial model that can be easily replicated.
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INTRODUCTION: Higher prevalence of extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli fecal carriage has been reported in the nosocomial setting than in the community. We tried to determine the fecal carriage of ESBL-producing E. coli among healthy volunteers in a relatively isolated community. MATERIALS AND METHODS: This study was conducted on 115 healthy adult volunteers from whom one fecal sample was collected and was plated on selective media. Each morphotypes were identified, characterized, and ESBL phenotype was confirmed by double-disk potentiation method. Molecular characterization of ESBL gene was done using multiplex polymerase chain reaction and pulse-field gel electrophoresis (PFGE) was done to identify their clonal relation. RESULTS: ESBL-producing E. coli had a prevalence of 19% (22/115) among the healthy volunteers in the community. CTX-M was the predominant type, showed a presence 95.5% (21/22), TEM 63%, SHV 9%, and both TEM and CTX-M were present in 63.6% (14/22), all three present in 4.5% (1/22). The lineage using PFGE showed a single clone in 17 isolates. Seven isolates were type A (all TEM & CTX-M), six were type A1 (all TEM & CTX-M except 2), four were type A2 (all CTX-M), and three belonged to types B, C, and D respectively Conclusion: High prevalence rate of 19% in the community indicated by this study implies the possibility of sustained ESBL carriage even among isolated population, which could serve as a reservoir for enriching the ESBL pool in the hospital. Clonal relations also indicate a possible epidemiological source that needs to be evaluated.
