Lessons from smallpox eradication campaign in Bihar State and in India.

Following several key breakthroughs during the mid-1960s under the global smallpox eradication programme namely, development of a thermo-stable vaccine, efficient and acceptable technique of it's delivery by bifurcated needle and evolution of a strategy (in lieu of mass vaccination) of active case search and containment, an intensified campaign of smallpox eradication from India was successfully implemented during 1973-1975. A formidable battle was fought, particularly in Bihar state leading to the occurrence of last indigenous case on 17 May 1975. The rapid achievement of eradication of the scourge from India in a record time was hailed as unprecedented in public health history. The single key factor in the achievement was the sustained efforts of a band of national and international epidemiologists, supported by young medical interns heading mobile containment teams, working under trying field conditions. Through the campaign several important lessons were learnt and innovations made. Important among these were: (i) need for refinement of tools, techniques, and strategies for attaining the objective; (ii) implementation of a time and target oriented campaign; (iii) support of adequate and dedicated short term personnel to supplement supervision and field activities; (iv) providing of flexible funding and a convenient disbursement procedure; (v) building private-public partnership; (vi) devising of simple innovations, based on feedback from field, to support activities; (vii) development of political commitment; (viii) improved communication from field to higher levels to enable action on recent information; (ix) regular periodic staff meetings at each administrative level to facilitate early recognition and correction of deficiencies; (x) mobilization of support from international community, whenever required.

Lessons from smallpox eradication campaign in Bihar state and in India.

Following several key breakthroughs during the mid-1960s under the global smallpox eradication programme namely, development of a thermo-stable vaccine, efficient and acceptable technique of it's delivery by bifurcated needle and evolution of a strategy (in lieu of mass vaccination) of active case search and containment, an intensified campaign of smallpox eradication from India was successfully implemented during 1973-1975. A formidable battle was fought, particularly in Bihar state leading to the occurrence of last indigenous case on 17 May 1975. The rapid achievement of eradication of the scourge from India in a record time was hailed as unprecedented in public health history. The single key factor in the achievement was the sustained efforts of a band of national and international epidemiologists, supported by young medical interns heading mobile containment teams, working under trying field conditions. Through the campaign several important lessons were learnt and innovations made. Important among these were: (i) need for refinement of tools, techniques, and strategies for attaining the objective; (ii) implementation of a time and target oriented campaign; (iii) support of adequate and dedicated short term personnel to supplement supervision and field activities; (iv) providing of flexible funding and a convenient disbursement procedure; (v) building private-public partnership; (vi) devising of simple innovations, based on feedback from field, to support activities; (vii) development of political commitment; (viii) improved communication from field to higher levels to enable action on recent information; (ix) regular periodic staff meetings at each administrative level to facilitate early recognition and correction of deficiencies; (x) mobilization of support from international community, whenever required.

Nanocrystalline gadolinium doped ceria: combustion synthesis and electrical characterization.

Twenty mol% gadolinium doped ceria powders were prepared by citrate-nitrate combustion synthesis technique. Two different sources of cerium viz. cerium nitrate and ammonium ceric nitrate were used in different oxidant-to-fuel ratios. The crystallite size of the synthesized powders ranged 5-27 nm was obtained depending on the preparation conditions with average particle size in the range 0.64-1.26 microm. Although, the powders were found to be agglomerated in nature, these powders were highly sinter-active as they showed very high sintered density (> or = 95%) when sintered at 1250 degrees C having grain size in the range of 200-500 nm. The electrical conductivity was found to depend on the temperature with two distinct regimes at a transition point of 350 degrees C. The grain boundary showed a significant role in the total conductivity with its activation energy dependent on the material preparation conditions. The activation energy of total conduction was found to be significantly low (-0.5 eV) in the temperature range of 400-700 degrees C, this property is unique for application as an electrolyte for solid oxide fuel cell operating in the low temperature range. It was found that a fuel-deficient combustion reaction using cerium nitrate as the oxidant yielded the best quality powder which showed a maximum electrical conductivity of -1.74 x 10(-2) S/cm at 600 degrees C.

Challenges in the final stage of polio eradication.

India and many other countries of the world have supported the resolution taken by the World Health Organization (WHO) in 1988 to eradicate poliomyelitis globally by the year 2000. At the beginning of 2002, there were 10 countries in the world with endemic transmission. India included in the high transmission area. WHO is preparing guidelines on the program response (both immunization and surveillance) to wild poliovirus isolation from the environment. This technology will be useful in monitoring the disappearance of vaccine virus after ceasing OPV vaccination.

Patients' reference for evening pay clinic at a tertiary care hospital.

To lessen overcrowding in the regular morning OPD and obtain better patient satisfaction, Evening Pay Clinic in a tertiary care hospital with daily OPD attendance between 1000 and 1200 patients was conceptualised. To elicit patients' response to the proposed system a survey with a structured questionnaire among 202 randomised sample of patients was conducted. Patient preference depended on distance of their home from the hospital as well as availability of suitable transport to reach the pay clinic and the likelihood of their being able to go back by the same evening after their encounter with the hospital was over. The majority of the patients preferred the proposed system as it promised quick and personalised service and the attendance by the doctors of their choice.

Issues involved in hospital waste management--an experience from a large teaching institution.

Experience from a large teaching hospital regarding hospital waste management is presented. The quantum of hospital waste generated is 0.775 kg. per patient per day. Out of this biomedical waste constitute only 6.27 per cent. Though all resources have been provided, a large implementation gap for waste management is seen because of attitudinal problem. A particular difficulty is experienced for disposal of green coconut shells. Incineration has been advocated as a viable method of disposal. Cost of incineration is Rs. 2.71 per patient per day.

Bilateral adrenal lymphoma presenting as Addison's disease.

We describe an unusual case of non-Hodgkin's lymphoma of the adrenals which presented as Addison's disease. Examination of tissue taken by computed tomography guided biopsy revealed a high grade B cell centroblastic lymphoma. The patient was treated with chemotherapy but died from invasive aspergillosis. Autopsy confirmed bilateral adrenal involvement by lymphoma.

Studies on in vitro culture supernatant of P. falciparum. Isolation of antigens for serology.

Twenty-four-hour-old in vitro culture supernatant of Plasmodium falciparum was collected and a comparative study was carried out using supernatant antigen and antigen prepared from in vitro culture of P. falciparum parasites in ELISA with sera from slide-positive malaria cases. The results were comparable, and in certain cases higher ELISA readings were observed with the supernatant antigen.