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Purpose: To estimate the prevalence of blindness and severe visual impairment (SVI) by using a door?to?door screening and vision center (VC) examination strategy in an urban area in western Maharashtra (Pune), India and repeat the exercise after 4 years to study its impact. Methods: Four trained community health workers measured the visual acuity and performed an external ocular examination in patients’ homes. People with vision <6/18 were requested to visit the VC for a comprehensive eye examination by an optometrist. An ophthalmologist examined people whose vision did not improve to 6/12. A home examination was done for people who did not visit the VC despite two requests. The same population was examined twice in an interval of 4 years. Results: In the study, 44,535 people in 2015–16 and 98.14% (n = 43,708) of them in 2018–19 were examined. Blindness (vision < 3/60 in better eye), and moderate?to?severe visual impairment (MSVI, vision 6/18–6/60 in better eye) were 0.26% and 1.3%, respectively, in the first cohort, and 0.16% and 1.1%, respectively, in the second cohort (P < 0.001). When the worse eye was considered, the prevalence of blindness reduced from 0.72% to 0.44%, SVI reduced from 0.1% to 0.07%, and MVI decreased from 1.7% to 1.49% between 2015 and 2019 (P < 0.001). Females (P < 0.001) and older individuals (P < 0.001) were more likely to have blindness or SVI. In the VC, 8211 people were examined in 4 years.Conclusion: The reduction of blindness and MSVI in the urban area of Pune can be partly ascribed to the presence of a VC and attendant screening in this locality.
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Background: Every day, relatively large amount of potentially infectious and hazardous wastes is generated in the health-care hospitals and facilities around the world. Indiscriminate disposal and improper management of waste generated in health care facilities causes serious threat to environment and to human health that requires specific treatment and management prior to its final disposal.Methods: Cross-sectional study was conducted among 241 health care personnel working at Mahatma Gandhi Memorial hospital, Warangal. Data was collected and pre and post analysis was done using a pre-validated self-administered questionnaire. Data was entered in MS Excel and analysed using SPSS 17 software.Results: Among 241 respondents, 33.2% were sanitary staff, 35.3% are nursing staff and 31.5% are nursing students. Only 35.7% of participants has knowledge regarding the colour of the bag into which expired antibiotics are discarded and 45.2% of participants were aware of the colour of the bag in which IV bottles, gloves were discarded. Scoring for 10 was done in both pre and post-test and post test scores were found to be higher and there is significant increase in level of knowledge of biomedical waste management rules in study population in post-test analysis (p<0.001).Conclusions: Training program on the waste management in the health sector has significant effect in increasing knowledge of the healthcare personnel
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BACKGROUND & OBJECTIVES: Tuberculous pleuritis is used as a model to understand the protective immune response in tuberculosis. It is predominated by Th1 response at the site of infection, where a possible role for the leptin, a known enhancer of Th1 response, could be speculated. Hence, we investigated leptin levels in pleural effusions in patients with both tuberculous (TP) and non-tuberculous (NTP) pleural effusion. METHODS: Leptin and cytokine levels were assessed in serum and pleural fluid of TP and NTP patients (N = 20 each) by ELISA. Multivariate regression analysis were performed to find the possible determinants of leptin taking leptin as the dependent and body mass index (BMI), gender, source of leptin [i.e., serum or pleural fluid (PF)], age and disease status as independent variables. RESULTS: PF leptin levels were significantly higher than serum leptin levels in both the groups however the PF leptin levels were significantly lower in TP subjects compared to NTP. The results showed that the leptin was found to be dependent on BMI but not on the other parameters. However, regression analysis based on the source of leptin showed males to be a better predictor of leptin. No correlation was observed between leptin and measured immune parameters. INTERPRETATION & CONCLUSION: Our findings demonstrated that the decreased leptin levels were associated with reduction in BMI but not with the disease status in tuberculous pleuritis.
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Adult , Age Factors , Aged , Body Mass Index , CD4 Lymphocyte Count , Cytokines/blood , Female , Humans , Leptin/blood , Male , Middle Aged , Sample Size , Tuberculosis, Pleural/bloodABSTRACT
BACKGROUND & OBJECTIVE: Acinetobacter spp., the only Gram negative commensal found on human skin are emerging nosocomial pathogens, and are rapidly developing multiple drug resistance. Most studies in India and over the world are on clinical and environmental Acinetobacter isolates. The present investigation was undertaken to study plasmid distribution and antibiotic resistance profile of Acinetobacter genospecies isolated from healthy human skin of a tribal population from western India. METHODS: One hundred and eighteen strains of Acinetobacter spp. were isolated from healthy human skin and biochemically classified into nine genospecies. Plasmid profiles were determined using four standard methods with minor modifications and by a commercial kit. Molecular weights were determined by comparison with standard plasmids pUC19, pBR322, RP4 and molecular weight marker, V517. Antimicrobial susceptibility patterns of Acinetobacter genospecies to 30 antibiotics belonging to different groups was determined using Kirby Bauer method. RESULTS: All isolates, except two showed a maximum of three plasmids with molecular size 1.5 to 40 kb. Five different plasmid types were observed. Only eight strains had one or two stably maintained low molecular weight plasmids in addition to 40 kb plasmid seen in most of the strains. Quinolones and aminoglycosides were most active group followed by, cephalosporins and beta lactams. INTERPRETATION & CONCLUSION: Acinetobacter spp. isolated from the tribal skin flora had low number of plasmids as compared to clinical and environmental isolates. Acinetobacter spp. harbouring low molecular weight plasmids were found to be sensitive to most of the antibiotics tested suggesting these might be coding for some other novel properties or may be cryptic, whereas, those having 40 kb plasmid showed intermediate to low level resistance to some antibiotics.