Profile of epileptic patients at a tertiary care centre

Background: The present study was done in a tertiary care centre of North India to know the profile of epilepsy.Methods: Total of 210 patients were selected during the period August, 2017 to July 2018 who attended outpatient clinic of the Department of Neurology, Indira Gandhi Medical College, Shimla, Himachal Pradesh. Detailed clinical history was taken, general physical examination, and routine blood examination were carried out.Results: Of all the cases, sex ratio (male:female) was 2.39:1. A high proportion of cases (43.3%) were from lower-middle socio-economic group. 76.7% patients had generalized seizures. For 38.6% patients, frequency of seizures was more than 8 in the past 6 months. 71.9% of the patients were using only one anti-epileptic drug.Conclusions: Patients with seizures comprise a significant burden in inpatient department of developing countries.

Sociocultural factors and malaria in the desert part of Rajasthan, India.

BACKGROUND & OBJECTIVES: Malaria is a new emerging problem of Indian Thar Desert. The study was attempted to find out some sociocultural factors associated with malaria transmission in this region and to supplement social solutions to ongoing malaria control efforts in the desert part of Rajasthan. METHODS: Interview technique was used for data collection on pre-tested schedules. In all 30 households (15 from low socioeconomic group and the same number of households from the high socioeconomic group) in a village were selected following systematic random sampling technique. A total of 450 respondents were selected randomly in 15 villages of Jaisalmer district, Rajasthan. RESULTS: One-third of the respondents had neither taken treatment for malaria nor took part in the vector control operations because they did not consider mosquito bites to be harmful and took malaria as a mild disease. Outdoor sleeping habits, sharing bed with children, uneasy and suffocation feeling in using mosquito bednets or any other protective device also contributed to the spread of malaria in the study villages. INTERPRETATION & CONCLUSION: Community should be educated as a whole particularly the low socioeconomic group of people to bring changes in their beliefs, sociocultural and health practices to protect themselves from mosquito bites by using bednets, repellents and other devices, such as wire mesh screening of house doors and windows.

Treatment seeking behaviour of malaria patients in desert part of Rajasthan, India.

Malaria remains to be the most important cause of morbidity and mortality in India and in many other tropical countries with approximately 2 to 3 million new cases arising every year. In spite of arid conditions prevailing in desert part of Rajasthan, malaria is a major public health problem. A longitudinal study on social determinants of malaria has been undertaken in different villages of Ramgarh PHC of Jaisalmer district, Rajasthan. The study aims to know treatment seeking behabiour of malaria patients in the desert communities which is significantly different than the non-desert part of India. Out of 60 villages, 12 villages and 573 malaria patients were selected randomly. Interview technique was used for data collection. Information was recorded on pre-tested schedules. Self diagnosis 423 (73.8%) was more common among the respondents and 443 (77.3%) had taken treatment at home with local herbal remedies as the first treatment action. Desert population was not used to laboratory test for the malaria diagnosis. Symptoms based treatment was practised. They used private and government health facilities for the treatment of malaria. Self diagnosis for malaria was common but practised more by the poorer households. A large part of the population did not complete the full course of malaria treatment as a result drug resistance was more common. They did not use the government health facility as a first step of malaria treatment. There is need for health education with campaign emphasizing the role of mosquitoes in malaria transmission and the need for prompt medical intervention. The use of Government health services for the diagnosis and treatment of malaria by the poor should be encouraged through appropriate information, education and communication (IEC) which on the long run will be more cost effective for desert population under the national malaria control programme.

Study of social determinants of malaria in desert part of Rajasthan, India.

BACKGROUND & OBJECTIVES: A longitudinal study on social determinants of malaria has been undertaken in different villages of Ramgarh PHC of Jaisalmer district, Rajasthan. The study aims to determine social determinants of malaria as applicable to existing cast groups of desert part of Rajasthan. METHODS: Out of 940 households in five villages, 150 households of Rajput community (forward community) and Meghwal community (backward community) were selected at random to study whether due to different behaviour of existing caste groups, transmission of malaria and its intensity also vary or not. RESULTS: It was found that magnitude of malaria was three times more in the Meghwal community as compared to Rajput community. In-migration of natives importing malaria was found to be prominent cause of more malaria incidence in the backward community. INTERPRETATION & CONCLUSION: An intervention policy aiming to study existing status of knowledge among different caste groups of desert areas could lead to a substantial control over in-migration as well as further transmission of disease in the desert part of Rajasthan.

Entomological studies on malaria in irrigated and non-irrigated areas of Thar desert, Rajasthan, India.

BACKGROUND & OBJECTIVES: Malaria is the major health problem in western Rajasthan yet its vector fauna and transmission dynamics thereof is not understood properly. The present investigations report complete profile of qualitative and quantitative aspects of anopheline species occurring in different settings of desert ecosystem. METHODS: Area with irrigation through canal for more than 20 years (setting I), area with irrigation through canal for 10 years (setting II) and area without any irrigation (setting III) have been selected for studies. Species identification and their densities (per man hour) was made as per standard methods. RESULTS: In village of setting I, during rainy season, An. subpictus and An. stephensi were present while during winter season four species--An. subpictus, An. stephensi, An. culicifacies and An. annularis were collected. In all the villages of setting I, II and III no Anopheles mosquito was observed during summer season. In the villages of desert region without any irrigation facilities through any canal, the anopheline species were present only during rainy season. INTERPRETATION & CONCLUSION: An. stephensi is the major malaria vector of desert irrespective of whether the area is canal irrigated or not. During summer season absence of vector species in all the villages require further studies on micro-ecology of the species under desert conditions.

Status of Soil Transmitted Helminth infections in an urban locality of Assam; as observed from survey by WHO sampling methodology for school children and community survey by random sampling.

In this study, an attempt was made to compare and correlate findings of a Soil Transmitted Helminths (STH) survey carried out using WHO sampling methodology for school children and community survey by random sampling. The prevalence and intensity of STH in the age-group of 9-10 yrs reportedly represent community status. The results showed that the STH prevalence and intensity in the age-group of 9-10 years do represent community burden. However, more such surveys will have to be carried out to substantiate this statement.

A new focus of cutaneous leishmaniasis in Himachal Pradesh (India).

This paper highlights a new focus of cutaneous leishmaniasis (CL) in the temperate area of Himachal Pradesh (India), a previously non-endemic area. In this hospital-based study, 38 new cases of CL, acquired indigenously have been detected from 1988-2000. Of these, 26 were from Kinnaur district and 12 from adjoining areas of bordering districts situated along the river: Satluj. There were 18 males and 20 females. They were between 4-75 years of age and had the disease for one month to 2 years at the time of presentation. Face involvement was seen in majority of the patients. Nodulo-ulcerative plaque was the commonest lesion. Muco-cutaneous lesions were seen in four cases. Tissue smears and biopsies were positive for LD bodies in 61.7% and 29.4% cases respectively. Intralesional sodium stibogluconate produced a consistent therapeutic response. The possible mode of its introduction in the region is postulated. The reservoir of infection, identity of the vector at this altitude (9,002,900 meters above sea level) and the strain of leishmania, remain to be identified.

Bancroftian filariasis in Bagdogra town, district Darjeeling (West Bengal).

Filaria endemicity is probably gradually increasing over the years in Bagdogra town, district Darjeeling (West Bengal). Of 1511 night blood smears examined, 35 were found positive for Wuchereria bancrofti (mf rate 2.32%). The microfilaria (mf) rates for males and females were 2.84% and 1.79 % respectively. The age of these positives ranged from 5-45 years. The mf rate was highest (4.46%) in the age group of 20-29 years. All mf carriers were local residents of Bagdogra and Wuchereria bancrofti was only the infection encountered. Mean microfilaria density was 7.71 per 20 cmm. of blood, whereas Median microfilaria density (MFD50) was 21 per 20 cmm. of blood. Disease and filarial endemicity rates were 0.33% and 2.65% respectively. Ten man hour vector mosquito density ranged from 30 to 65. Out of 49 female Culex quinquefasciatus mosquitoes dissected for the presence of filaria infection, none was found positive for the infection. During 1976 survey in the same town, mf rate was 1.6% and disease rate was nil.

Breeding habitats and larval indices of Aedes aegypti (L) in residential areas of Rajahmundry town, Andhra Pradesh.

Entomological studies on relative prevalence and distribution of adults and immatures of Aedes aegypti were conducted in Rajahmundry town of Andhra Pradesh from December 1998 to November 1999. Adults and immature stages of Aedes aegypti were found in all the 22 localities viz; posh area (8), mixed area (8) and slum area (6) of the town. Larval indices were found to be higher in slum areas as compared to mixed or posh areas of the town. However, the larval habitats were observed to be similar in all localities. The larval indices were highest during monsoon and post-monsoon months. The breeding preference ratio (BPR) was highest for cement tubs followed by discarded tyres and barrels. The high larval indices of Aedes aegypti in these areas warrant intensification of vector surveillance activities along with source reduction and health education.

Status of soil transmitted helminthic infections in India--observations on sample surveys using Kato-Katz technique.

Results of surveys conducted in eight different ecologically homogenous zones in the country, using WHO sampling design methodologies and Kato-Katz technique are presented in this communication. Hilly and coastal areas had high STH prevalence ranging from 34%-36% with total epg ranging from 53,952-4,67,976. Apart from this, Chitradurga urban area had STH prevalence of 39.6% with epg of 81,792. However, except in few cases, in all these surveyed areas, intensity of STH infection was found to be light. A national programme for control of soil transmitted helminthic infections is advocated.

A study of filarial transmission in a non-endemic area of Pathankot (Punjab).

A filariasis survey was conducted in July 1998 in Pathankot town of Punjab covering a population of 28, 041. A total of 2136 blood smears were collected from migratory and local inhabitants. Microfilaria (Mf) rate and mean Mf density was 1.19 and 15.05 respectively. Disease rate was nil. All the 20 microfilaria carriers detected were known to hall from filaria endemic areas of different states. Mf rate was highest in 20-49 years age-group, whereas Mf density was high in younger age group. Wuchereria bancrofti was the only infection encountered. 10 Men Hour Density of Culex quinquefasciatus ranged between 343 in the North Command unit to 400 in an engineering unit. A total of 339 female Culex quinquefasciatus were dissected. None was found positive for human microfilaria parasite, thus negating any indigenous filariasis transmission in this town. These findings were compared to earlier surveys in the same area and other non-endemic areas. Non-endemic areas continue to be non-endemic for filariasis despite considerable increase in MF rate among migratory population and vector density.

Early development of acute filariasis in a migrant from non-endemic to hyper endemic area: a case report.

A case report of a European woman who contracted filariasis after staying for a few weeks in a filaria endemic area of south India is presented in this paper.

Operational research in malaria--why and how?

Research studies conducted so far have had little bearing on the National Malaria Eradication Programme implementation for want of operational component. In India there is no dearth of scientific knowledge and technical know-how but dearth of operational research of direct relevance to the programme. The rationale for research under the operational conditions of the NMEP is discussed in this paper.

Status of Plasmodium falciparum resistance to chloroquine in Orissa.

Orissa is known for its contribution of 15-20% of malaria cases to the national total. Deaths due to malaria in the state are also not uncommon. Proportion of P. falciparum cases have reached to 85%. In the recent years over 0.3 million confirmed malaria cases have been reported each year. Annual consumption of chloroquine in the state is over 170 lakh tablets. A 17 year study on monitoring of choloroquine resistance in P. falciparum in Orissa revealed that out of a total of 1165 tests conducted in vivo, in 12% of the cases RI level of resistance was detected. And 4.4% cases were of RII and 1.9% RIII level. 51% of the sample tested in vitro showed P. falciparum resistance to chloroquine. P. falciparum resistance to chloroquine appears to have been developed by the parasite over the length and breadth of the state. Strengthening of the monitoring of drug resistance in P. falciparum in the state is indicated.

Accuracy of self reporting malaria in Orissa--a case study.

For rapid assessment of malaria in difficult forested areas in Orissa a study on the accuracy of self-reporting of malaria showed 72 per cent accuracy along with the sensitivity and specificity values of 46 per cent and 76 per cent respectively. The study clearly indicates its utility in the ongoing national malaria eradication programme and can be effectively used for rapid assessment of the disease prevalence. The information so gathered can be used for rapid assessment by the planners and programme managers in devising the strategies for the containment of malaria in the forested areas of Orissa.