River rejuvenation in urban India for enhancing living conditions through integrated water resources management.

India, being a developing country, faces big challenges in ensuring water, sanitation, and hygiene (WASH) for all. This case study presents the performance evaluation of a large wastewater management and sanitation-related infrastructure in a metropolitan city in North India. "Dravyavati River Project" is the major sanitation program of the water-stressed Jaipur city based on the concept of river rejuvenation of the long-lost Dravyavati River which flows across the city. The project envisages integrated urban water management such that it aims at the collection and treatment of wastewater (sewage network and treatment plants), safe disposal, ensuring continuous unpolluted flow, geological and ecological integrity to strengthen public health, to reduce the impact of water stress on the total water cycle by promoting groundwater recharge, and improvement in biodiversity. The technical assessment is based on the primary and secondary data collection of field samples and laboratory analysis of influent and effluent samples collected from the five sewage treatment plants (STPs). The results suggest that the project has largely delivered the envisaged environment, public well-being, and ecological and socioeconomic benefits, but there are substantial gaps in the conceived outputs and actual performance. The challenge lies in bridging these gaps and overcoming operational inefficiencies to ensure the sustainability of the Dravyavati River rejuvenation.

Hydrochemistry and groundwater quality assessment around solid waste landfill sites in peri-urban Jaipur, NW India.

Jaipur, the capital city of Rajasthan State in northwestern India, is one of the fastest-growing urban centers in the country. The city and the region around it have documented a substantial drop in the water table due to the over-abstraction of groundwater resources to cater to the increasing water demands of the growing population. Consequently, the entire Jaipur district has been categorized as a "dark zone," prohibiting any further groundwater development activity. Besides its dwindling availability, water quality is also a matter of concern. In places, the water is geogenically contaminated and unsuitable for drinking purposes due to high levels of undesired elements in groundwater, such as high fluoride in the southern part and high chloride in the southwestern part of the district. Groundwater contamination can also occur through several anthropogenic factors, such as industrialization and excessive use of insecticides and pesticides. Water pollution through sewage disposal in open land-fill sites is also an important factor, especially in the growing urban centers. In this study, the water quality evaluation around three landfill sites in the Jaipur district, namely Mathura Das Pura and Langadiyawas (east of the city) and Sewapura (northwest of the city), was carried out. The cation-anion analysis of 45 groundwater samples collected around these sites reveals a wide variation in the abundance of constituent parameters. In a majority of cases, most of the parameters are within acceptable limits prescribed by the national and international agencies (Bureau of Indian Standards and World Health Organization). The fluoride content is more than the prescribed limit of 1.5 mg/l in several cases. This could be an intrinsic property of deeper aquifers. The majority of Mathura Das Pura and Langadiyawas samples classify as Na + K - CO3 + HCO3 to Mg - CO3 + HCO3 types in the Piper classification scheme, while a small proportion shows mixed water type characteristics, i.e., with no dominant parameter. Most of the samples have heavy metal abundances within the permissible limits while slightly elevated Cd and Pb levels were observed in some samples. A positive correlation between these two metals can be attributed to a common pollutant, possibly sourced from solid waste. The percent pollution index of Sewapura samples shows lower pollution levels (PPI < 40%) and a dominant chemical weathering trend while the majority of Mathura Das Pura-Langdiyawas samples show a high pollution effect (PPI 40 to 80%). In general, the chemical parameters of Sewapura (relatively new landfill site) samples define a more coherent group while water quality parameters in Mathura Das Pura and Langdiyawas (old landfill sites) samples show a wide variation, unsystematic distribution, and significantly higher than prescribed values for most of the hydrochemical parameters. The study shows that some of the water quality issues may be geogenic, while municipal waste dumping and leachate infiltration have adversely affected the groundwater quality.

Application of analytical hierarchical process, multi-influencing factor, and geospatial techniques for groundwater potential zonation in a semi-arid region of western India.

Groundwater resources are alarmingly depleting due to over-exploitation and significant climate changes over time. Therefore, demarcation of groundwater potential zones is essential for addressing the needs of various industries in semi-arid area. Depleting groundwater resources, topography, aquifer features and climatic factors make it necessary to demarcate ground water potential zones in semiarid region of Rajasthan. The Analytical Hierarchy Process (AHP), Geographic Information System (GIS), and Multi Influence Factor (MIF) were used to determine the groundwater potential zones (GWPZs) in the semi-arid region of Jaipur, located in western Rajasthan. In present study, ten influential factors were employed i.e., geomorphology, land use/land cover (LULC), drainage density, rainfall, topographic wetness index (TWI), soil texture, slope, roughness, topographic position index (TPI) and curvature. In AHP technique, the pairwise comparison matrix was generated, and weightages were given to each thematic layer while for MIF, a proposed score for each layer was computed from the aggregate weight of major and minor effects. The GWPZ map generated by AHP technique was categorised into three parts: high, moderate and poor potential zones, covering 13%, 50.7% and 36.3% of the district. While, the GWPZ map produced with the MIF technique was also divided into the same poor, moderate, and high categories, encompassing 35.3, 44.1, and 20.6% of the district, respectively. The results of AHP and MIF techniques were then cross-validated with well depth data obtained from CGWB report, 2019-20. The receiver operating characteristics (ROC) were plotted and the findings shows that the Area under the Curve (AUC) was 79% and 76% for AHP and MIF, respectively which is considered as moderate to high in predictive precision. The study would be helpful in locating drilling sites for groundwater exploration and developing sustainable groundwater and land use policies.

Vaginal pH Estimation, an Additional Tool for RTI/STI Community Screening.

Objective: To study laboratory evidence of infection in STI/RTI cases managed by syndromic approach. To evaluate vaginal pH estimation as an additional supplementary tool for community screening of STI/ RTI cases. Material and Methods: Study was conducted in department of Gynecology and Obstetrics, Mahila Chikiksalaya Sanganeri gate Jaipur in collaboration with Department of Microbiology, SMS Medical College Jaipur, Rajasthan. STI cases screened by syndromic approach attending the STI clinic were included in study. Vaginal pH of these cases was measured with help of Jaipur pink V strip. Cases with vaginal pH more than five and less than 5 were grouped separately. Evidence of infection was assessed in both groups by performing predefined battery of tests. Results of both the groups were analyzed. Results: Laboratory evidence of infection was seen in 78% of syndromically screened RTIs/STI cases while screening by combined approach, i.e., syndromic approach and Vaginal pH estimation both, showed positive predictability of 92% with 75% sensitivity and 79% specificity. Conclusion: Laboratory evidence of infection was found in 92% of RTI/STI cases when screened by combined approach as compared to 78% in syndromic approach alone. Vaginal strips being user friendly can be used as additional tool for community screening of RTI/STI.

Assessment of Fluoride Content in Water and Its Impact on the Intelligence Quotient of School Children Aged 12-13 Years.

BACKGROUND: The preliminary study was undertaken with the aim to assess the effect of fluoride content in water on the Intelligence Quotient (IQ) of school children aged 12-13 years residing in areas that differ with respect to fluoride levels. MATERIALS AND METHODS: The IQ was measured using Raven's Colored Progressive Matrices in 90 children, who were life-long residents in three villages (30 children each) of similar population size but differing in the level of fluoride in drinking water. Urinary fluoride concentration was measured using the selective ion electrode technique. One-way ANOVA was used for the statistical analysis of the data. Results: Children who lived in locations with fluoride levels of 1.60, 6.70, or 2.80 parts per million in their drinking water had urinary fluoride concentrations of 1.60, 6.82, or 2.69 parts per million, and IQ scores of 16.77 + 8.24, 19.36 + 9.98, or 21.87 + 7.47, respectively. CONCLUSION: The results indicated that there was a positive correlation between excess fluoride in drinking water and IQ.

Comparison of Antero-Posterior Lip Position in Most Favored Facial Profile of Jaipur Population.

Background The enhancement of facial esthetics is one of the essential goals of orthodontic treatment. The concept of an excellent facial profile can differ between two individuals of the same population. Esthetics is a very vital component in Orthodontic diagnosis and treatment planning. Orthodontic treatment aims to achieve facial harmony by stabilizing the occlusion and pleasing facial and dental esthetics. Therefore, the characteristics of a pleasing, well-balanced face and a functioning occlusion should be evaluated. Aim This study aimed to determine preferable Antero-posterior lip positions in the Jaipur population and determine the range of anteroposterior lip positions as evaluated by orthodontists, patients, and professionals from a series of different lip positions in facial silhouettes, and compare their assessments. Materials and Methods The sample comprised 50 subjects (25 males & 25 females) from Jaipur. All angular and linear measurements were recorded for both males and females separately. The mean value of those readings was placed in NEMOTECH cephalometric software, and an average profile construction was done. This average profile will determine the lip fullness/ facial profile of males and females of the Jaipur (Rajasthan) population. A series of 7 profile silhouettes for males and seven profile silhouettes for females was developed by altering the lip positions (protrusion & retrusion in 2mm increments till 6 mm from the average profile) parallel to Frankfort horizontal plane (F-H) plane. Constructed facial silhouettes (seven male and female) were evaluated by (50) Orthodontists, (50) oral surgeons, general dentists (50), and non-specialists population (100). Evaluators were asked for the best profile in each gender from 1 to 7 in order of their preference. Result On calculating the standard deviation values, the profile selected as most favored for females is 2.33 by orthodontists, on the contrary, the standard deviation for Oral Surgeons, General Dentists & Non-specialists is 2.04, 2.14, and 2.12 respectively. It was found that profile retruded -2mm for males was the most favored, and profile retruded -4mm for males was second most favored. Average Profile /the profile without retrusion or protrusion was selected by orthodontists as the most favored profile. Profile retruded -2mm was the most favored profile for males clinically significant. It was found that profile retruded -2mm for females was the most favored, and profile retruded -4mm for females was second most favored. Profile retruded -2mm was the most favored profile for females by Orthodontists, General Dentists & non-specialists. Profile retruded -4mm was the most favored for females by Oral Surgeons. overall made insignificant. Conclusion The most favored facial profile is -2mm (profile 1) retruded lip posture in both males and females. According to Orthodontists most favored facial profile is 0mm (profile 6) average profile in males and -2mm (profile 1) retruded lip position in females. According to non-specialists most favored facial profile is -2mm (profile 1) retruded lip position in both males and females.

Association of Early Childhood Caries with Feeding, Dietary Habits, and Oral Hygiene Practices among Rural and Urban School Children of Jaipur.

Aim: To determine possible associations of early childhood caries (ECC) with risk factors such as feeding and dietary habits of children and oral hygiene practices by the parents or caregiver in rural and urban school children in Jaipur, India. Materials and methods: An observational cross-sectional study was designed with a dental examination and a standardized questionnaire. A total of 1,824 children, that is, 848 (46%) rural, and 976 (54%) urban school children were enrolled in the study. The data regarding their diet and feeding habits of children, oral hygiene practices of the parents or caregivers were collected with the help of a standardized questionnaire. The caries status of rural and urban school children was recorded using the decayed, missing, filled teeth (DMFT) index. Data thus collected were compiled, analyzed and were subjected to statistical analysis using Statistical Package for Social Sciences (SPSS v 26.0, IBM). Comparison of frequencies of categories of variables with groups was done using Chi-square test with p < 0.05 was considered to be statistically significant. Results: The prevalence of ECC was 34.7% in rural and 45.5% in urban school children of Jaipur (p < 0.01). Caries risk increased with the use of both bottle and breast feeding, habit of milk at night, eating snacks between meals with no habit of rinsing teeth, and decrease in parental supervision during oral hygiene practices. In urban school children there is an increased access to junk food and refined sugar daily as compared to rural school children with more than two times in a week was found statistically highly significant in the study (p < 0.01). Conclusion: The prevalence of ECC was higher in urban school children as compared to rural school children in Jaipur. It was found that risk factors such as diet and feeding habits of children and oral hygiene practices by the parents or caregiver are strongly associated with the prevalence of ECC. It was concluded that the epidemiological data, which have been collected in a very comprehensive way can be utilized more effectively to eliminate the root cause of the disease by improving oral health services in the rural and urban school children in Jaipur, India. How to cite this article: Yadav SP, Meghpara M, Marwah N, et al. Association of Early Childhood Caries with Feeding, Dietary Habits, and Oral Hygiene Practices among Rural and Urban School Children of Jaipur. Int J Clin Pediatr Dent 2022;15(3):273-279.

Correlación entre pruebas y escalas de valoración funcional en el seguimiento a la adaptación protésica de personas con amputación de miembro inferior / Correlation among tests and functional assessment scales in the follow-up of prosthetic adaptation in people with lower limb amputation

Introducción: Existe gran disponibilidad de pruebas funcionales y escalas para evaluar distintos aspectos en la adaptación de personas amputadas, pero aún no hay consenso respecto a las más apropiadas. Objetivos: Describir las medidas de correlación y asociación entre tres pruebas funcionales para amputados de miembros inferiores y definir cuál es la más adecuada. Evaluar la satisfacción general de los usuarios de prótesis de miembro inferior y su asociación con las pruebas funcionales. Métodos: Se incluyeron 83 personas con amputación unilateral de miembro inferior, usuarios de prótesis exomodulares de bajo costo. Instrumentos: escala de Houghton, la subescala de movilidad del cuestionario de evaluación protésica y la prueba de marcha de 2 minutos (2MWT). El análisis estadístico se realizó mediante la prueba chi cuadrado y el coeficiente de correlación de Spearman. Resultados: Las pruebas funcionales tuvieron una correlación y asociación aceptable entre sí, la correlación entre la escala de Houghton y el 2MWT fue de mayor magnitud (r=0,56 para la muestra total; r=0,53 para amputados debajo de rodilla). Las medidas de asociación no lograron resultados estadísticamente significativos para amputados por encima de la rodilla, ni para la satisfacción general. Conclusiones: La escala de Houghton y el 2MWT mostraron una buena correlación y asociación entre sí por lo que pueden ser considerados como instrumentos de primera línea para el seguimiento de los usuarios de prótesis exomodulares de miembro inferior. Para la satisfacción general no se identificó asociación importante con los instrumentos evaluados.(AU)

Introduction: There is a wide variety of functional tests and scales for the assessment of different aspects in the adaptation of amputees, but there is still no consensus on which are the most appropriate. Objectives: To describe the measures of correlation and association among three functional tests for lower-limb amputees and to define the most appropriate for this assessment. To assess general satisfaction in lower-limb prostheses users and its association with the functional tests. Methods: We included 83 unilateral lower-limb amputees who were users of low-cost exoskeletal prostheses. The instruments employed were the Houghton scale, the Prosthesis Evaluation Questionnaire - Mobility Scale (PEQ-MS) and the 2-minute walk test (2MWT). The statistical analysis was performed using the chi-square test and Spearman's correlation coefficient. Results: The functional tests evaluated had an acceptable correlation and association with each other, but the Spearman correlation between the Houghton scale and the 2MWT was of greater significance (whole sample: r=0.56; below-knee amputees: r=0.53). The association measures did not achieve statistically significant results for above-knee amputees or for general satisfaction. Conclusions: The Houghton Scale and the 2MWT showed a good correlation and association with each other, becoming possible first-line instruments for the follow-up of exoskeletal lower limb prosthesis users. No significant association was identified between satisfaction and the instruments measured.(AU)

[Correlation among tests and functional assessment scales in the follow-up of prosthetic adaptation in people with lower limb amputation]. / Correlación entre pruebas y escalas de valoración funcional en el seguimiento a la adaptación protésica de personas con amputación de miembro inferior.

INTRODUCTION: There is a wide variety of functional tests and scales for the assessment of different aspects in the adaptation of amputees, but there is still no consensus on which are the most appropriate. OBJECTIVES: To describe the measures of correlation and association among three functional tests for lower-limb amputees and to define the most appropriate for this assessment. To assess general satisfaction in lower-limb prostheses users and its association with the functional tests. METHODS: We included 83 unilateral lower-limb amputees who were users of low-cost exoskeletal prostheses. The instruments employed were the Houghton scale, the Prosthesis Evaluation Questionnaire - Mobility Scale (PEQ-MS) and the 2-minute walk test (2MWT). The statistical analysis was performed using the chi-square test and Spearman's correlation coefficient. RESULTS: The functional tests evaluated had an acceptable correlation and association with each other, but the Spearman correlation between the Houghton scale and the 2MWT was of greater significance (whole sample: r=0.56; below-knee amputees: r=0.53). The association measures did not achieve statistically significant results for above-knee amputees or for general satisfaction. CONCLUSIONS: The Houghton Scale and the 2MWT showed a good correlation and association with each other, becoming possible first-line instruments for the follow-up of exoskeletal lower limb prosthesis users. No significant association was identified between satisfaction and the instruments measured.

Distribution of Cutaneous Malignancies in Eastern Rajasthan: A Five-Year Study.

Background: Cutaneous malignancies are rare with respect to other malignancies. The distribution of various histologies of these malignancies is not uniform. We aimed to study the distribution of these malignancies and their epidemiological pattern in Eastern Rajasthan with the data collected from various pathology labs in Jaipur. Methods: In this retrospective chart review we analysed the data of 453 patients presenting with histopathologically proven cutaneous malignancies to four major pathology departments and labs in Jaipur, Rajasthan. We recorded the distribution of these histologies according to incidence, age of presentation, gender and site predilection. The data was subsequently analysed using statistical methods. Results: Squamous cell carcinoma (36%)was the most common histology which was closely followed by basal cell carcinoma(31%). Malignant melanoma (13%) was the third most common histology to present. Other less common histologies to present were dermatofibrosarcoma, Kaposi sarcoma, non hidgkin lymphoma etc. The age range varied from 14 to 90 years. The mean age of presentation was 54.3 years. Male had a slight preponderance (1.36 times more than females)overall. Except Bcc, which had a female preponderance. Head and neck(38.41%) was the most common site to be affected overall followed by lower limbs(31.56%). Interpretation: The idea of distribution of these rare malignancies in our part of the country will not only help us in proper surgical management but also in educating the public about the possible causes and the need for early intervention leading to better prognosis.

Post Herpetic Neuralgia: A Retrospective Study to Evaluate Response to Modified Jaipur Block with Increased Concentration of Dexamethasone.

BACKGROUND: Postherpetic neuralgia (PHN) is a complication of herpes zoster characterized by persistent dermatomal pain. It has a negative impact on the quality of life. There is no gold standard therapy for PHN, and various local and systemic treatments have been tried. There are studies reporting the use of combination of steroids and local anesthetics but there is no standardized method. AIM: To evaluate the response of modified Jaipur block with increased concentration of dexamethasone. METHODS: We conducted a retrospective study in patients who were given Jaipur block. The patients age, sex, duration of PHN, type and severity of pain were observed. A combination of 2% lignocaine and 0.5% bupivacaine and dexamethasone was injected subcutaneously. The pain was scored using visual analogue scale at the baseline, and 1 month after 1st, 2nd, and 3rd session of block and follow up after 6 months and 1 year. RESULTS: The mean age of our patient was 63.33 ± 9.5 years. The males outnumbered females. Thoracic dermatomes were more commonly involved. The mean duration of PHN was 11.58 ± 12.76 months; stimulus evoked PHN was the commonest type of pain seen. The mean visual analogue score (VAS) decreased progressively after each session of the block. Maximum patients (50%) had excellent response, whereas 1.9% did not respond to the block. Relapse of pain was seen in 5.6% of the patients. There was no significant side effect noted. LIMITATIONS: There was no objective method used to assess pain. CONCLUSION: PHN is chronic neuropathic pain. Response to modified Jaipur block is good, but if the duration of PHN is more, the recurrence rate is higher. Modified Jaipur block is an effective and safe treatment for PHN.

Parametric Design and Hybrid Fabrication of Above-Knee Prosthesis.

BACKGROUND: India has a large number of above-knee amputation patients who require a prosthetic leg that is affordable, conformal, functional, and durable. Available low-cost solutions, such as Jaipur foot, employ gypsum plaster in the process of fabricating a fitting socket. This has four shortcomings: (1) requirement of trained technicians, (2) high possibility of manual errors leading to rework, (3) long production time of several hours, and (4) difficulty in scaling up for widespread application. MATERIALS AND METHODS: An improved approach is presented here, which combines computer-aided parametric design and numerically controlled machining with manual thermoforming to overcome the above issues. The socket is semi-automatically designed based on 60 parameters, derived from 23 measurements obtained on the natural stump of a patient. The three-dimensional (3D) computer-aided design model of the socket can be used for additive manufacturing (3D printing), which was found to be accurate, but time-consuming and expensive. Hence, a hybrid process was evolved with the following three steps: computer numeric control machining of the stump and shank replica in polyurethane (PU) foam, followed by coating with suitable epoxy, and finally high-density polyethylene pipe thermoforming over the PU foam replicas. RESULTS: Three prostheses were fabricated using both conventional and hybrid processes and provided to volunteer patients. The hybrid process resulted in 28% reduction in overall fabrication time and improved satisfaction of patients due to better fit and comfort. CONCLUSION: The proposed approach can be adapted for mass customization, required to meet the large gap in demand and supply, especially in resource-constrained settings.

CAD/CAE of Jaipur foot for standardized and contemporary manufacturing.

Objective: Despite immense popularity of Jaipur foot as low cost prosthetic, not much work has been reported on its design for manufacturing standardization. Without manufacturing standardization, it cannot be mass produced using contemporary manufacturing technologies. The objective of this work is to carry out its computer aided design (CAD) followed by computer aided engineering (CAE) based on the material properties obtained from the previous work [1] of the authors. This may lead to the possible use of modern manufacturing processes for the Jaipur foot design.Design: After modelling using CAD tool including its organic surfaces, the designed foot was analysed using a CAE tool for balanced standing load conditions to determine maximum stresses and deformation in its various parts. The bending analysis was done to check the dorsiflexion movement so that the strained sections could be identified for more reliable and durable prosthetic foot. For the static load analysis, base of the foot was constrained and 300-500 N load was applied through the bolt whereas for bending, the part near the bolt was fixed and pressure was applied at junction of front foot and toes.Results: The results show that the maximum stress and deformation occur at the bolt, while the skin undergoes maximum strain. CAE analysis also proves the robustness of the Jaipur foot design and a well manufactured Jaipur foot as per standardized design should be able to withstand the real life conditions without failure. The CAD model is also used for FDM based printing for a nonfunctional prototype of Jaipur foot.Implications for rehabilitationThe results of this study will serve as an important guideline for further research regarding equivalent material replacement, material optimization and obtaining an optimized design after studying the foot for dynamic analysis.

Performance Evaluation of Jaipur Knee Joint through Kinematics and Kinetics Gait Symmetry with Unilateral Transfemoral Indian Amputees.

Gait analysis is considered as the most systematic study of human motion. The analysis of gait includes visual and analytical perception of the individual, augmentation of various mechanical instrumentations for measuring movement of body, muscles activity and body mechanics. Past study focused on gait analysis of various animal locomotion and humans mainly on sports biomechanics. This paper aims to quantify the gait performance with Jaipur Knee, which is one of the most widely used prosthesis in Indian population. Gait data with Jaipur knee joint is not available till date. The proposed study targets to predict the performance of Jaipur knee joint in terms of gait symmetry with transfemoral Indian amputees. Gait symmetry may be the basis of recommendation of knee joint to prosthetic patients. This study used kinematics and kinetics parameters together to quantify the performance of Jaipur knee joint to evaluate gait symmetry. This research will be helpful for clinician to predict and further to prevent the degenerated musculoskeletal effects generally seen in unilateral transfemoral amputees.

Assessment of the compressive and tensile mechanical properties of materials used in the Jaipur Foot prosthesis.

BACKGROUND: Designed by Dr. Sethi, the Jaipur Foot prosthesis is ideally suited for amputees in developing countries as it utilizes locally sourced, biodegradable, inexpensive materials and is focused on affordability and functionality. To date, however, no data have been reported on the material properties of the foot components. OBJECTIVES: The goal of this work was to evaluate mechanical properties of the Jaipur Foot components to guide foot design and manufacturing and reduce weight. STUDY DESIGN: Experimental. METHODS: Mechanical testing was conducted on two types of woods (ardu and cheed), microcellular rubber, tire cord, cushion compound, tread compound, and skin-colored rubber. Each material was subjected to testing in either tension or compression based on its location and function in the foot. Samples were tested before and after vulcanization. Two-sample t-tests were used to assess statistical differences. RESULTS: Cheed compressed perpendicular to the grain had a significantly higher modulus of elasticity than ardu ( p < 0.05); however, cheed had a higher density. Vulcanization significantly increased the modulus of skin-colored rubber, cushion compound, and tread compound ( p < 0.05) and decreased the moduli of both microcellular rubber and tire cord ( p < 0.05). CONCLUSION: The material property results from this study provide information for computer modeling to assess material construction on overall foot mechanics for design optimization. Ardu wood was ideal based on the desire to reduce weight, and the tire cord properties serve well to hold the foot together. Clinical relevance With new knowledge on the material properties of the components of the Jaipur Foot, future design modifications and standardized fabrication can be realized, making the Jaipur Foot more available on a global scale.

Prevalence, Demographic Profile, and Psychological Aspects of Epilepsy in North-Western India: A Community-Based Observational Study.

AIMS: This study was undertaken to determine the prevalence of active epilepsy, assess the sociodemographic profile, and psychological aspects of epilepsy in the Jaipur district of Rajasthan, India. METHODS: We conducted a community-based, cross-sectional observational study covering both rural (n = 165,660) and urban (n = 179,142) populations of Jaipur district using a house-to-house survey. An adapted, pre-designed World Health Organization screening questionnaire was used to identify the cases. Those confirmed by neurologists as true seizures were included in the study. Cases were classified as per the International League against Epilepsy recommendation. Global Mental Health Assessment Tool electronic questionnaire was used to analyze psychological aspects of cases. The caregivers of the patients participated in the knowledge, attitude, and practice (KAP) survey. RESULTS: A total of 380 patients (258 men, 122 women) were identified with active epilepsy. The estimated prevalence of active epilepsy was 1.1/1,000 population and 71% of cases belonged to low socioeconomic classes. Primary treatment gap was documented in 18.8% of cases in our study, 38% of cases were non-compliant to treatment with poorer compliance in those on pol-therapy, 76% had some psychiatric disorder, anxiety and depression being the commonest, and positive family history of epilepsy was found in 4.7%. KAP survey revealed that only 15% of the respondents believed that epilepsy is non-curable, 74% denied its infectious nature, 26% believed that epilepsy occurs due to past sins, and 81% said that they would not marry persons with epilepsy. CONCLUSION: A relatively low prevalence (1.1/1,000) of active epilepsy and a smaller primary treatment gap (18.8%) was found in our study population. Almost three-fourth of cases had an associated psychological problem, Though caregivers were aware of the nature of disease, majority would not prefer to marry a person suffering from epilepsy.

Epidemiological study of failures of the Jaipur Foot.

OBJECTIVE: The purpose of this study was to examine effects of usage and demographics on damage to the Jaipur Foot prosthesis as well as the epidemiology and etiology of amputations performed at Santokba Durlabjhi Memorial Hospital (SDMH) in Jaipur, India. DESIGN: Total time spent standing, total time spent wearing and total distance walked were compared against severity and location of damage to the prosthesis. Time between initial fitting and follow-up visit for damaged prosthetic was also considered in this analysis. A novel damage severity scale based on prosthesis functionality is presented along with a damage location legend. RESULTS: Patients from 10 different states and two territories throughout India were included in the study. No main effects were found to be statistically significant in predicting severity or location of damage. Only the interaction between a patient's total time spent standing and their total time spent wearing the prosthesis as well as the interaction between a patient's total time spent standing and total distance walked was significant in predicting location of damage to the Jaipur Foot (p = .0327, p = .0278, respectively). CONCLUSIONS: The lack of significant usage factor effect on damage severity or location could support previous findings that lack standardization in materials and manufacturing processes, which is the major drawback of the Jaipur Foot. Implications for Rehabilitation The Jaipur Foot is a safe, reliable and stable product as no abrupt breakage or sudden falls causing injury to the patient were noted. Hence, it is a safe rehabilitation device for lost limbs. The population can squat and sit cross-legged while wearing the prosthetic foot and it does not affect damage severity or location of damage, allowing for these activities to be performed while rehabilitating. The manufacturing of the foot needs to be standardized to improve life of foot. Total time spent standing, total time spent wearing and total distance walked were not predictive of severity or location of damage to the prosthesis, hence providing patient guidelines for activity during rehabilitation.

Improved design and development of a functional moulded prosthetic foot.

PURPOSE: In the Indian scenario, the Jaipur foot is a low-cost breakthrough that enabled the disabled person to adapt to the Indian environment. The aim of this study is to modify the present foot in terms of ankle support design and method of fabrication, foot moulds profile and the inner core material in order to improve the performance and durability. METHOD: The optimized design of ankle support and flat foot profile moulds suitable for both left and right foot were developed through CAD/CAM and prosthetic feet were fabricated using ethylene vinyl acetate (EVA) foam as an appropriate alternative core material for microcellular rubber (MCR). The developed prosthetic feet were tested for rigidity by load-deflection analysis in universal testing machine. RESULT: EVA foot had shown better rigidity than conventional MCR foot, which will help in weight transfer during walking and increase the durability. The CAD modeled ankle support and single block EVA had made the manufacturing process easy and reduced the weight of foot and improved Gait to the person fitted with it due to improved flat foot profile. CONCLUSION: The new artificial foot had proven to be efficacious technically as well as functionally, which is clearly borne out from the extremely positive feedback given by the amputees. Implications of Rehabilitation Persons with below knee amputation are usually provided with transtibial prosthesis, which allows for easier ambulation and helps them to get back to their normal life. Transtibial prosthesis is an artificial limb that replaces a lower limb that is amputated below the knee. In our study, a new prosthetic foot with a modified ankle support and flat foot profile using better inner-core material than the conventional Jaipur foot was developed and the process was also optimized for mass production. The developed prosthetic foot can be fitted with both above and below knee exoskeleton type of prosthesis.

A hospital based serosurveillance study of dengue infection in jaipur (rajasthan) , India.

BACKGROUND: Dengue has been known to be endemic in India for over two centuries. There is a need to assess the magnitude of dengue virus establishment in the state of Rajasthan. A surveillance study was conducted to analyze dengue seropositivity among patients with clinical suspicion of dengue fever like illness, who presented to or were admitted at a tertiary care private hospital at Jaipur. METHODS: Serum samples from 2169 suspected dengue cases (1356 males and 813 females) were received in the Serology lab over the four year study period (2008-2011). The samples were subjected to a rapid immuno-chromatography assay with differential detection of IgM and IgG antibodies. A primary dengue infection was defined by a positive IgM band and a negative IgG band, whereas a secondary infection was defined by a positive Ig G band with or without an IgM band. RESULT: Among the 2169 patients who were screened; 18.99% (412) were dengue specific IgM positive cases. 64. 49% (1399) cases were negative for dengue specific antibodies, 5.67% (123) were primary dengue cases, and 23.51% (510) were total secondary dengue cases. During the study period, the Dengue IgM seropositivity was highest in the year 2009 and was lowest in the year 2011. Most of the cases occurred in the post-monsoon season, with a peak in the month of October, each year. CONCLUSION: A detailed and continuous epidemiological surveillance is required, for monitoring the incrusion and spread of dengue viruses. This will help in undertaking and implementing effective control and management strategies.