Mapping of traditional healthcare providers and their healing approaches in a tribal community of district Sirohi, Rajasthan.

Introduction: Traditional applications of medicinal plants in healthcare practices provide indication to new therapeutic concepts; hence, their relevance is highly recognized. The objective of the study was to map the traditional healers from the aspirational district and scientific documentation of their healing practices to treat various diseases. Method: This was community-based study in tribal subpopulation zone of district Sirohi. The data was collected through field survey and interviews of tribal healers by using semi-structured questionnaire. Result: We identified 1015 tribal healers (68% male and 32% female), and all belong to Bhil, Meena, and Garasia communities of district Sirohi. The mean age was 60.45 ± 16.56 years, 82.6% healers were uneducated, and 12.6% had primary education, while 1.2% were graduates. Tribal healers act as primary point of care for tribal community and practiced various treatment modalities including herbal healing (32.7%), diviners (28.9%), child birth attendant (24.7%), and bone setters (13.7%). We recorded 88 herbal healing practices from tribal communities of district Sirohi and scientifically documented. The common diseases treated by tribal healers included wound healing, skin infection, fever, arthritis, pain, diarrhea, cough, and cold. The Fabaceae family was credited with highest number (17%) of plants used by herbal healers. It was also noted that some of the plants used for medicinal purpose are endangered and overexhausted. Conclusion: Ethnopharmacological data is the foundation for further validation and value addition of herbal healthcare practices. The mapping of indigenous knowledge holders and scientific documentation of their knowledge might be a crucial step for providing clue regarding new therapeutic molecules.

Performance-based protocol for selection of economical portable sensor for air quality measurement.

An effective micro-level air quality management plan requires high-resolution monitoring of pollutants. India has already developed a vast network of air quality monitoring stations, both manual and real time, located primarily in urban areas, including megacities. The air quality monitoring network consists of conventional manual stations and real time Continuous Ambient Air Quality Monitoring Stations (CAAQMS) which comprise state-of-the-art analysers and instruments. India is currently in the early stages of developing and adopting economical portable sensor (EPS) in air quality monitoring systems. Protocols need to be established for field calibration and testing. The present research work is an attempt to develop a performance-based assessment framework for the selection of EPS for air quality monitoring. The two-stage selection protocol includes a review of the factory calibration data and a comparison of EPS data with a reference monitor, i.e. a portable calibrated monitor and a CAAQMS. Methods deployed include calculation of central tendency, dispersion around a central value, calculation of statistical parameters for data comparison, and plotting pollution rose and diurnal profile (peak and non-peak pollution measurement). Four commercially available EPS were tested blind, out of which, data from EPS 2 (S2) and EPS 3 (S3) were closer to reference stations at both locations. The selection was made by evaluating monitoring results, physical features, measurement range, and frequency along with examining capital cost. This proposed approach can be used to increase the usability of EPS in the development of micro-level air quality management strategies, other than regulatory compliance. For regulatory compliance, additional research is needed, including field calibration and evaluating EPS performance through additional variables. This proposed framework may be used as starting point, for such experiments, in order to develop confidence in the use of EPS.

Quantitative assessment and mitigation measures of air pollution from crematoria in NCT of Delhi.

The modernization of crematoria and replacement of existing fuel requirements for better air quality is a key challenge in view of the associated religious beliefs in India where conventional open pyre funeral practices are followed. Unlike developed nations, the lack of appropriate site selection criteria, combustion efficient crematorium oven designs, and pollution control devices at these facilities necessitates formulation of appropriate policy measures to reduce emissions. The existing practices do not address such localized sources that affects the micro air pollution patterns owing to their marginal contribution in the total air pollution load of the city. The present study is thus an attempt to estimate emissions from 51 cremation grounds identified in NCT of Delhi. The study considers both particulate and gaseous pollutants which are released due to burning of fuels like wood, CNG, and cow dung. It is estimated that cremation activities contributed 393 tons/year of PM2.5, 142 tons/year of NOx, 29 tons/year of SO2, and 2686 tons/year of CO in year 2019. The maximum load was emitted from Central district as only Nigambodh Ghat crematoria receives on an average 60 bodies per day. Furthermore, air quality impact zone around crematoria has been demarcated using dispersion modelling considering crematorium with minimum and maximum number of bodies burnt in a day. The study also suggests control measures for reduction of pollution from cremation activities and delineates a buffer zone that could aid policymakers in establishing a site selection criterion to prevent the immediate population from likely exposure.

Identification of air pollution hotspots in urban areas - An innovative approach using monitored concentrations data.

Critical assessment of spatio-temporal variations in pollution levels is a crucial step for identifying and prioritizing air pollution hotspots (APH) in urban areas. There is no universally accepted methodology for defining and delineating air pollution hotspot which can be source-specific, pollutant-specific and time-specific. The present research article is an attempt to develop a protocol for identifying APH for any pollutant within a city where-in three criteria-based innovative methodology has been derived. The three criteria are frequency of exceedance (% of days), scale of exceedance and consistency in exceedance (consecutive number of days) to the specified standards that need to be met continuously for at least three years. The suggested methodology has been applied on a three-year database (2018-2021) of 37 continuous ambient air quality stations to identify PM2.5 specific APH. The analysis indicates 11 APH in April, 9 in May, 2 in June and almost the entire city during the October-February months. Given prioritization of implementation of control actions, the identified APH during summer has been further physically examined to map source activity types and their suitability for ambient air quality monitoring stations as per the guidelines. The APH can be the priority areas for the implementation of control actions by urban local bodies. The management of air pollution at these priority areas would be more effective instead of city-scale management practice, which is difficult to implement and monitor.

Infra-orbital nerve block using alar base approach: A novel landmark and technique.

The infra-orbital nerve block is given to anaesthetize the anterior part of maxilla by depositing the local anesthetic agent in proximity of the infra-orbital nerve foramen. The two intra-oral approaches well documented in the literature are the 'central incisor approach' or the 'bicuspid approach'. In 2011, Infra-orbital nerve block with extended coverage using the intra-oral 'molar approach' was employed. However, infra-orbital nerve block can pose a challenge in patients with no teeth. We have devised a novel landmark and technique for infra-orbital nerve block using the anatomical landmark alar base.

Assessment of the effectiveness of policy interventions for Air Quality Control Regions in Delhi city.

Government has implemented various scattered and un-quantified control actions in Delhi city to reduce the air pollution levels; however, it still exceeds the National Ambient Air Quality Standards (NAAQS). The present study has been designed to assess the air quality status, identify Air Quality Control Region (AQCR), and evaluate control strategies in the city. Out of eight selected locations, ambient PM10, PM2.5, and NO2 concentrations were found exceeding the daily as well as annual standards at selected AQCR with peak levels during post-monsoon than winter and summer. Anand Vihar was found to be most polluted and thus, selected as an AQCR. AERMOD performed satisfactorily in predicting pollutant concentration during winter and summer having an index of agreement in the range 0.54-0.80. PM10 and PM2.5 can be reduced substantially by increasing frequency of efficient mechanized cleaning of roads and sprinkling of water on the roads. Progressive decrease in NO2 concentrations can be achieved by restricting entry of truck in the study area through alternate path. The cumulative impact of all selected control strategies indicates a substantial decrease in air pollution within AQCR. The study also suggests a policy framework to manage the urban air quality through local scale air quality guidelines.

Fluid supplementation in management of neonatal hyperbilirubinemia: a randomized controlled trial.

OBJECTIVE: To evaluate the efficacy of oral or intravenous fluid supplementation in accelerating the decline of serum bilirubin with intensive phototherapy among healthy term and late preterm neonates with hyperbilirubinemia. STUDY DESIGN: This open-label randomized controlled trial randomized neonates with severe hyperbilirubinemia (serum total bilirubin ≥18 mg/dL or within 2 mg/dL of threshold for exchange transfusion) to receive 50 mL/kg of intravenous fluid over 8 h (IVF group, n = 51), 50 mL of oral rehydration solution over 8 h (oral rehydration solution (ORS) group, n = 50) or only standard therapy (control group, n = 49). Intensive phototherapy was administered in all the three study groups. RESULT: Over 8 h of intervention, serum bilirubin declined by 15.5% (95% CI: 11.7-19.4%) in IVF group, by 9.1% (95% CI: 7.3-10.9%) in ORS group and by 8.0% (95% CI: 6.2-9.7%) in control group (p < .001). Percent decline in serum bilirubin serum total bilirubin (STB) was significantly greater in IVF group as compared to ORS (mean difference: -6.4% 95% CI: -1.9 to -11.0) and control (mean difference: -7.6% 95% CI: -3.0 to -12.1) groups. Duration of phototherapy and proportion of neonates needing exchange transfusion were comparable in the three study groups. CONCLUSIONS: Intravenous fluid supplementation may result in a faster decline of STB in first few hours of treatment. However, with the use of intensive phototherapy, there was no effect on overall duration of phototherapy or need of exchange transfusion. CLINICAL TRIAL REGISTRATION: Clinical trial registry of India: REF/2015/09/009775.

Clinical and radiographic comparison of various medicaments used for pulpotomy in primary molars: A randomized clinical trial.

OBJECTIVE: To evaluate and compare the efficacy of ferric sulfate, glutaraldehyde, and mineral trioxide aggregate (MTA) as pulpotomy medicaments in primary molars. MATERIALS AND METHODS: This was a perspective randomized clinical trial. A total of 90 molars from 42 children aged 4-8 years were selected for pulpotomy procedure. Teeth were randomly divided into three equal groups of 30 teeth each. Teeth in Group I were intended to be treated with ferric sulfate, Group II were intended to be treated with buffered glutaraldehyde and Group III with MTA. All the molars were evaluated clinically at 24 h and both clinically and radio graphically at 1, 3, and 6 months. The observations were statistically analyzed using Chi-square test and Fisher's exact test. RESULTS: After 1 month, there was no clinical finding observed in all the three groups. At 3 months postoperative evaluation, 13.3% of teeth in Group I and 12.5% of teeth in Group II had mobility. At 6 months interval, pain and sinus formation each was noted in 9.1% of primary teeth in Group I while periodontal ligament widening was reported in 66.7% of teeth in Group I and 85.7% of teeth in Group II. CONCLUSION: MTA exhibited overall best results as pulpotomy agent for primary molars followed by 15.5% ferric sulfate, whereas 2% buffered glutaraldehyde was found to be least effective as a pulpotomy agent.