First report of molecular confirmation and phylogenetic analysis of ocular seteriasis in buffalo in India using 12S rRNA.

An adult Indian buffalo (Bubalus bubalis) presented with corneal opacity, irritation, and excessive lacrimation from the left eye in the Referral Veterinary Polyclinic-Teaching Veterinary Clinical Complex (RVC-TVCC), Indian Veterinary Research Institute, Izatnagar. Clinical examination revealed a whitish thread-like worm in the left eye's anterior chamber. The worm was surgically removed from the eye with supportive nerve blocks. Light microscopy was used for parasite morphological identification, which provided insight into the worm as female Setaria sp. Genomic DNA was isolated, and polymerase chain reaction amplification of 12S rRNA was conducted for molecular confirmation of the parasite. The amplicon was sequenced and analysed by bioinformatics software. Sequence data showed an amplicon size of 243 bp. Phylogenetic analysis with reference data from the NCBI Genbank database revealed the worm was S. digitata, with a similarity of 99.17%. The common predilection site of S. digitata is in the peritoneal cavity of natural hosts like cattle and buffalo and is mostly non-pathogenic. The aberrant migration of the parasite larva to the brain and eye commonly occurs in goats, sheep, and horses, causing clinical conditions like cerebrospinal nematodiasis (lumbar paralysis) and ocular setariasis, respectively. Nevertheless, until now, there have been no reports of ocular setariasis in buffalo. This report is the first unusual occurrence of ocular setariasis in buffalo and its molecular confirmation and phylogenetic analysis using 12S rRNA.

Inhalation Score - a Novel Technique for Assessing Severity of Inhalational Burns in Correlation to Bronchoscopic Findings.

Airway edema following burns is a typical occurrence. It poses a threat, independent of percent Total Burn Surface Area (TBSA), to the life of the patient. Fiber optic bronchoscopy is the gold standard in its diagnosis and is preferred if the facilities are present. Its availability remains a problem in the majority of burn centers in developing countries like India. Ascoring system based on clinical findings, if formulated in a manner that reflects bronchoscopy results, may help not only with diagnosis but also with airway management in inhalation burns. One hundred patients suffering from facial burns were included in the study. They were observed clinically and bronchoscopically and airway was managed on the basis of clinical, biochemical and bronchoscopic findings. Fifty patients who showed significant bronchoscopic findings on day 1 were followed up. Clinicobronchoscopic correlation revealed a positive correlation of various clinical variables as well as bronchoscopic grading with subsequent need for endotracheal intubation. Edema of tongue/floor of the mouth and palatal edema showed a positive correlation with subsequent need for tracheostomy. This clinicobronchoscopic correlation was then used retrospectively to formulate the Safdarjung Hospital 'INHALATION' score. This score can be used for predicting impending airway compromise when bronchoscopy facilities are not readily available.

La survenue d'un œdème des voies aériennes est un classique après une brûlure, entraînant un risque indépendant de la surface atteinte. L'endoscopie bronchique est l'examen diagnostique de référence et doit être réalisée si le matériel est disponible, ce qui est problématique dans les pays en développement dont l'Inde. Un score reflétant les données endoscopiques peut aider non seulement au diagnostic mais aussi au traitement des lésions d'inhalation. Cette étude a porté sur 100 patients ayant une brûlure faciale, ayant bénéficié d'un examen clinique et endoscopique et traités selon ces données et celles de la biochimie. La moitié des patients avaient des anomalies endoscopiques au premier examen. Les données cliniques (dont un œdème de la langue, du plancher buccal ou du palais) et endoscopiques prédisaient bien la nécessité d'une trachéotomie. Ces corrélations nous ont permis de développer le score INHALATION de l'hôpital Safdarjung, qui peut permettre de prédire une complication ventilatoire quand l'endoscopie n'est pas disponible.

Performance and Stability of Pearl Millet Varieties for Grain Yield and Micronutrients in Arid and Semi-Arid Regions of India.

Pearl millet [Pennisetum glaucum (L.) R. Br.] is grown under both arid and semi-arid conditions in India, where other cereals are hard to grow. Pearl millet cultivars, hybrids, and OPVs (open pollinated varieties) are tested and released by the All India Coordinated Research Project on Pearl Millet (AICRP-PM) across three zones (A1, A, and B) that are classified based on rainfall pattern. Except in locations with extreme weather conditions, hybrids dominate pearl millet growing areas, which can be attributed to hybrid vigor and the active role of the private sector. The importance of OPVs cannot be ruled out, owing to wider adaptation, lower input cost, and timely seed availability to subsidiary farmers cultivating this crop. This study was conducted to scrutinize the presently used test locations for evaluation of pearl millet OPVs across India, identify the best OPVs across locations, and determine the variation in grain Fe and Zn contents across locations in these regions. Six varieties were evaluated across 20 locations in A1 and A (pooled as A) and B zones along with three common checks and additional three zonal adapted checks in the respective zones during the 2019 rainy season. Recorded data on yield and quality traits were analyzed using genotype main effects and genotype × environment interaction biplot method. The genotype × environment (G × E) interaction was found to be highly significant for all the grain yield and agronomic traits and for both micronutrients (iron and zinc). However, genotypic effect (G) was four (productive tillers) to 49 (grain Fe content) times that of G × E interaction effect for various traits across zones that show the flexibility of OPVs. Ananthapuramu is the ideal test site for selecting pearl millet cultivars effectively for adaptation across India, while Ananthapuramu, Perumallapalle, and Gurugram can also be used as initial testing locations. OPVs MP 599 and MP 600 are identified as ideal genotypes, because they showed higher grain and fodder yields and stability compared with other cultivars. Iron and zinc concentration showed highly significant positive correlation (across environment = 0.83; p < 0.01), indicating possibility of simultaneous effective selection for both traits. Three common checks were found to be significantly low yielders than the test entries or zonal checks in individual zones and across India, indicating the potential of genetic improvement through OPVs.

Effect of dietary synbiotic supplementation on growth, immune and physiological status of Labeo rohita juveniles exposed to low pH stress.

In this study, we investigated the effect of dietary Bacillus circulans PB7 (BCPB7) and fructoligosaccharide (FOS), used singly or in combination for evaluation of growth, immune and physiological status of Labeo rohita (rohu) juveniles reared under low pH and normal pH for 60 days. Experimental fishes were distributed in two sets such as one set continuously exposed to low pH (5.5) and other reared under normal pH (7.0), and fed with four iso-nitrogenous diets viz. basal (control), Bacillus circulans PB7 (BCPB7, 106 cfug-1), 1% fructooligosaccharide (FOS) and their combination. The effect of such pre, pro and synbiotics dietary treatments on growth performance (weight gain, specific growth rate, feed conversion ratio and protein efficiency ratio), immune response (hematological indices, serum biochemistry, lysozyme, NBT activity), antioxidative status in the form of antioxidant enzyme (catalase, superoxide dismutase, glutathione-S-transferase), acetylcholine esterase (AChE), Na+ K+ ATPase and stress bio-markers (cortisol, glucose and HSP-70) were examined. The group treated with low pH and fed with control diet (without supplementation) was found to be inhibited (p  <  0.05) in growth and immuno-physiological function. However, supplementation of BCPB7 and FOS was non-significant (p < 0.05) on growth performance and physiological process but their concurrent feeding remarkably improved (p < 0.05) growth and immune-physiological function when exposed to low pH. Overall results indicate that dietary combination of BCPB7 and FOS can be considered an effective synbiotic formula against low pH stress in culture practices of L. rohita juveniles.

Ontogeny of the digestive tract in stinging catfish, Heteropneustes fossilis (Bloch) larvae.

Heteropneustes fossilis (Bloch) is an important candidate species for diversification of freshwater aquaculture in India. However, high mortality rate during larval rearing is the most serious bottleneck in commercial production of this species. A proper understanding of the ontogenic development of digestive system provides the basis to understand the nutritional physiology of larvae and develop appropriate feeding strategies. In the present study, the ontogenical development of the digestive tract in H. fossilis larvae was studied from hatching until 30 day post-hatching (dph) at 29 °C. At hatching (2.8 ± 0.2 mm standard length, SL), the digestive tract was undifferentiated and attached dorsally to the yolk sac. At 1 dph (2.9 ± 0.2 mm SL), the mouth opened and oral valves were visible. At 2 dph (3.0 ± 0.3 mm SL), goblet cells were observed in the buccoparyngaeal cavity. At this age, exogenous feeding started and the intestine was differentiated into the anterior and posterior regions, and the rudimentary liver and pancreas were also seen. Small supranuclear vacuoles were observed in the enterocytes of the posterior intestine at 2 dph. Zymogen granules were observed in acinar cells of pancreas by 3 dph, and islets of Langerhans were visible at 4 dph (3.5 ± 0.1 mm SL). At the same age, most of the yolk sac reserves were consumed, whereas they were completely exhausted by 5 dph (3.9 ± 0.5 mm SL). Between 4 and 6 dph, the liver elongated in size and started to accumulate lipids in the hepatocytes. Gastric glands were detected at 4 dph, and the pyloric sphincter was completely differentiated at 9 dph (6.1 ± 0.4 mm SL) as an epithelial fold that separated stomach from the anterior intestine. By 13 dph (8.6 ± 0.2 mm SL), profuse gastric glands were visible inside longitudinal mucosal folds of the stomach. The formation of gastric glands and their development were noticed as the last events in the development of the digestive tract in H. fossilis. This indicated the end of the larval period and the commencement of the juvenile stage. Considering these observations, it is suggested that H. fossilis larvae have a morphologically complete digestive tract by 13 dph. The findings of the study on the development of the digestive system in H. fossilis may help in synchronising the larval stage of development and feeding strategies and would be helpful in improving larval rearing techniques for catfish species.

Epidemiology of pediatric burns and future prevention strategies-a study of 475 patients from a high-volume burn center in North India.

BACKGROUND: Pediatric burns have a long-term social impact. This is more apparent in a developing country such as India, where their incidence and morbidity are high. The aim of this study was to provide recent prospective epidemiological data on pediatric burns in India and to suggest future preventive strategies. METHODS: Children up to 18 years old admitted to the Department of Burns, Plastic & Maxillofacial Surgery, VMMC & Safdarjung Hospital, New Delhi, between January and December 2014 were included in the study. Data regarding age, sex, etiology, total body surface area (TBSA), circumstances of injury, and clinical assessment were collected. The Mann-Whitney test or Kruskal-Wallis test or ANOVA was used to compare involved TBSA among various cohort groups accordingly. Univariate and multivariate linear regression analyses were used to determine the predictors of TBSA. RESULTS: There were a total of 475 patients involved in the study, including seven suicidal burns, all of whom were females with a mean age greater than the cohort average. Age, type of burns, mode of injury, presence or absence of inhalation injury, gender, and time of year (quarter) for admission were found to independently affect the TBSA involved. Electrical burns also formed an important number of presenting burn patients, mainly involving teenagers. Several societal issues have come forth, e.g., child marriage, child labor, and likely psychological problems among female children as suggested by a high incidence of suicidal burns. CONCLUSIONS: This study also highlights several issues such as overcrowding, lack of awareness, dangerous cooking practices, and improper use of kerosene oil. There is an emergent need to recognize the problems, formulate strategies, spread awareness, and ban or replace hazardous substances responsible for most burn accidents.

A thiocyanopalladation/carbocyclization transformation identified through enzymatic screening: stereocontrolled tandem C-SCN and C-C bond formation.

Herein we describe a formal thiocyanopalladation/carbocyclization transformation and its parametrization and optimization using a new elevated temperature plate-based version of our visual colorimetric enzymatic screening method for reaction discovery. The carbocyclization step leads to C-SCN bond formation in tandem with C-C bond construction and is highly stereoselective, showing nearly absolute 1,2-anti-stereoinduction (5 examples) for substrates bearing allylic substitution, and nearly absolute 1,3-syn-stereoinduction (16 examples) for substrates bearing propargylic substitution. Based upon these high levels of stereoinduction, the dependence of the 1,2-stereoinduction upon cyclization substrate geometry, and the generally high preference for the transoid vinyl thiocyanate alkene geometry, a mechanistic model is proposed, involving (i) Pd(ii)-enyne coordination, (ii) thiocyanopalladation, (iii) migratory insertion and (iv) ß-elimination. Examples of transition metal-mediated C-SCN bond formation that proceed smoothly on unactivated substrates and allow for preservation of the SCN moiety are lacking. Yet, the thiocyanate functionality is of great value for biophysical chemistry (vibrational Stark effect) and medicinal chemistry (S,N-heterocycle construction). The title transformation accommodates C-, O-, N- and S-bridged substrates (6 examples), thereby providing the corresponding carbocyclic or heterocyclic scaffolds. The reaction is also shown to be compatible with a significant range of substituents, varying in steric and electronic demand, including a wide range of substituted aromatics, fused bicyclic and heterocyclic systems, and even biaryl systems. Combination of this new transformation with asymmetric allylation and Grubbs ring-closing metathesis provides for a streamlined enantio- and diastereoselective entry into the oxabicyclo[3.2.1]octyl core of the natural products massarilactone and annuionone A, as also evidenced by low temperature X-ray crystal structure determination. Utilizing this bicyclic scaffold, we demonstrate the versatility of the thiocyanate moiety for structural diversification post-cyclization. Thus, the bridging vinyl thiocyanate moiety is smoothly elaborated into a range of derivative functionalities utilizing transformations that cleave the S-CN bond, add the elements of RS-CN across a π-system and exploit the SCN moiety as a cycloaddition partner (7 diverse examples). Among the new functionalities thereby generated are thiotetrazole and sulfonyl tetrazole heterocycles that serve as carboxylate and phosphate surrogates, respectively, highlighting the potential of this approach for future applications in medicinal chemistry or chemical biology.

Pulmonary Hypoplasia Wrongly Diagnosed and Treated as Pulmonary Tuberculosis.

Pulmonary hypoplasia (PH), a rare congenital anomaly is observed with incomplete development of the lung, and may be associated with anomalies in other body systems. The clinical presentation varies with the extent of hypoplasia and the patient may be asymptomatic or may present with severe respiratory distress in the neonatal, infancy or childhood period. A six year old girl suffering from right sided hypoplasia was hospitalized with common presenting chest symptoms. She had taken antituberculosis treatment for past three years and was thought to be an MDR suspect. The child was thoroughly investigated was diagnosed to be a case of PH and is under followup.

Determinants of respiratory diseases in East Sikkim.

BACKGROUND: Due to the difficult geographic terrain with lack of roads and transport, the Sikkim State in India finds difficulties in contending the respiratory diseases especially during the rainy seasons. FINDINGS: A case-control study was conducted for two months at the Central Referral Hospital of East Sikkim involving 110 individuals in the age group of 10 years and above. Due to feasibility constraints, 55 cases and 55 controls were selected by applying the non-probability sampling method with age and sex matching. The collected data were tabulated and analyzed by using the SPSS (Statistical Package for Social Sciences) version 10.0 for windows. Findings were expressed in terms of proportion, Chi Square Test and Multiple Logistic Regression Analysis. Here, p-value <0.05 was considered as statistically significant. This study revealed that the presence of overcrowding, chronic exposure to allergens, smoking habits, chronic respiratory illnesses within last 5 years, family history of chronic respiratory illnesses and mental illnesses were independently associated with respiratory diseases. CONCLUSION: This study should be replicated in other parts of Sikkim to obtain more confirmatory evidence on determinants of respiratory diseases.

Prevention of vertical transmission of HIV in India through service integration: lessons from Mysore District, Karnataka.

Meeting the needs of HIV-positive pregnant women and their offspring is critical to India's political and financial commitment to achieving universal access to HIV prevention, treatment, care and support. This review of the strategy to prevent vertical transmission of HIV in Mysore district, Karnataka, highlights the need to integrate prevention of parent-to-child transmission (PPTCT) and reproductive and child health (RCH) services. All key officials who were involved in the integration of services at the state and district levels were interviewed by use of semistructured protocols. Policy documents and guidelines issued by the Department of Health and Family Welfare and Karnataka State AIDS Prevention Society were reviewed, as were records and official orders issued by the office of District Health and Family Welfare Officer and District HIV/AIDS Programme Office, Mysore. Routine data were also collected from all health facilities. This review found that 4.5 years of PPTCT-RCH integration resulted not only in a rise in antenatal registrations but also in almost all pregnant women counselled during antenatal care undergoing HIV tests. Based on the findings, we propose recommendations for successful replication of this strategy. Integration of PPTCT services with RCH should take place at all levels - policy, administration, facility and community. The increased demand for HIV counselling and testing resulting from service integration must be met by skilled human resources, sufficient facilities and adequate funds at the facility level.

Burn wound: How it differs from other wounds?

Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock while whole blood loss is the cause of shock in other acute wounds. Even though the burn wounds are sterile in the beginning in comparison to most of other wounds, yet, the death in extensive burns is mainly because of wound infection and septicemia, because of the immunocompromised status of the burn patients. Eschar and blister are specific for burn wounds requiring a specific treatment protocol. Antimicrobial creams and other dressing agents used for traumatic wounds are ineffective in deep burns with eschar. The subeschar plane harbours the micro-organisms and many of these agents are not able to penetrate the eschar. Even after complete epithelisation of burn wound, remodelling phase is prolonged. It may take years for scar maturation in burns. This article emphasizes on how the pathophysiology, healing and management of a burn wound is different from that of other wounds.

Awareness regarding risk factors, symptoms and treatment facilities for cancer in selected states of India.

OBJECTIVE: To study the level of awareness and knowledge about cancers and associated risk factors among households in selected states of India. METHODS: In the study 3070 households were interviewed from six states viz, West Bengal, Kerala, Madhya Pradesh, Rajasthan and Mizoram. RESULTS: Knowledge of cancers other than those related to tobacco was very low (prostate 8%, colon 11% ) among the communities, with a poor awareness of warning signs and symptoms. The knowledge varied from state to state. It is found that the major source of information related to cancers was television (38%) followed by friends and relatives (36%). Only about 15 % of respondents had knowledge about cancer awareness camps organized in their districts but they did not have knowledge about the organizers of the camp. Findings suggested a strong need for strengthening of DCCP. CONCLUSION: It is important to create awareness among community through educational programs on cancer prevention, preventable cancer risk factors, benefits of early diagnosis, and availability of screening facilities. Integration of District Cancer Control activities with NRHM could be the most cost-effective strategy to prevent cancers and rural population.

Firecracker injuries during Diwali festival: The epidemiology and impact of legislation in Delhi.

SETTING AND DESIGN: A hospital-based retrospective study of firecracker-related injuries was carried out at a government sponsored hospital in Delhi. MATERIALS AND METHODS: 1373 patients attended the emergency burn care out-patients clinic during 2002-2010 pre-Diwali, Diwali and post-Diwali days. Every year, a disaster management protocol is revoked during these 3 days under the direct supervision of the Ministry of Health and Family Welfare, Government of India. RESULTS: There was an increase in the number of patients of firecracker-related injuries in Delhi national capital region from the year 2002 to 2010, based on the hospital statistics. During the study period, the hospital received approximately one patient with firecracker-related injury per 100,000 population of the city. 73.02% of the victims were 5-30 years old. Majority (90.87%) of them sustained <5% total body surface area burn. CONCLUSIONS: In spite of legislations and court orders, the number of patients is on the rise. The implementation agencies have to analyse the situation to find a way to control this preventable manmade accident. Websites, emails, SMS, social sites, etc. should be used for public education, apart from conventional methods of public awareness.

Changing pattern of fungal infection in burn patients.

Invasive fungal burn wound infection is an important emerging cause of late onset morbidity and high mortality in patients with major burns. Following a pilot study done in our unit in 1 year, i.e. January 2008-March 2009 in 71 patients where 28% (20 patients) of the burn wound biopsies from suspected cases showed fungal wound invasion (FWI), a detailed study was planned in order to study the epidemiology of fungal infection in burns in our unit wherein routine wound biopsies in 100 patients were sent on 7th, 14th and 21st postburn day over a one year period (July 2009-June 2010). 12 patients (12%) were diagnosed with FWI on culture. This was then followed by another study in a 9 month period (July 2010-March 2011) when wound samples for only 36 patients in whom there was clinical suspicion of fungal infection were sent. 16 of these patients were diagnosed with fungal wound invasion (FWI) thus establishing an incidence of 44% from suspected cases. These studies showing the increase in fungal infection in our unit have therefore made us wiser, increased our awareness and our accuracy in diagnosing this uncommon infection in extensive burns where patient is not only severely immunocompromised but also has many other risk factors making them more vulnerable to fungal invasion. Another glaring fact which emerged from these studies was the rising incidence of nonalbicans Candida infection compared to Candida albicans, especially C. tropicalis and C. krusei which are more severe in nature and associated with a higher mortality. This signifies that there is a shift of FWI in burns from commensal organism, i.e. C. albicans to pathogenic nosocomial organisms, i.e. C. nonalbicans.

Transcriptional regulation of Wnt inhibitory factor-1 by Miz-1/c-Myc.

The Wnt signaling pathway is capable of self-regulation through positive and negative feedback mechanisms. For example, the oncoprotein c-Myc, which is upregulated by Wnt signaling activity, participates in a positive feedback loop of canonical Wnt signaling through repression of Wnt antagonists DKK1 and SFRP1. In this study, we investigated the mechanism of Wnt inhibitory factor-1 (WIF-1) silencing. Mapping of CpG island methylation of the WIF-1 promoter reveals regional methylation (-295 to -95 bp from the transcription start site) that correlates with transcriptional silencing. We identified Miz-1 as a direct activator of WIF-1 transcriptional activity, which is found at WIF-1 promoter. In addition, we show that c-Myc contributes to WIF-1 transcriptional repression in a Miz-1-dependent manner. Although the transient repression mediated by Miz-1/c-Myc is independent of de novo methylation, the stable repression by this complex is associated with CpG island methylation of the critical -295 to -95-bp region of the WIF-1 promoter. Importantly, Miz-1 and c-Myc are found at WIF-1 promoter in WIF-1 non-expressing cell lines DLD-1 and 209myc. Transient knockdown or somatic knockout of c-Myc in DLD-1 failed to restore WIF-1 expression suggesting that c-Myc is involved in initiating rather than maintaining WIF-1 epigenetic silencing. In a genome-wide screen, DNAJA4, TGFß-induced and TRIM59 were repressed by c-Myc overexpression and DNA promoter hypermethylation. Our data reveal novel insights into c-Myc-mediated DNA methylation-dependent transcriptional silencing, a mechanism that might contribute to the dysregulation of Wnt signaling in cancer.

A method to produce radiation hybrids for the D-genome chromosomes of wheat (Triticum aestivum L.).

Radiation hybrid (RH) mapping is based on radiation-induced chromosome breakage rather than meiotic recombination, as a means to induce marker segregation for mapping. To date, the implementation of this mapping approach in hexaploid (Triticum aestivum L.; 2n = 6x = 42; AABBDD) and tetraploid (T. turgidum L.; 2n = 4x = 28; AABB) wheat has concentrated on the production of mapping panels for individual chromosomes. In order to extend the usefulness of this approach, we have devised a method to produce panels for the simultaneous mapping of all chromosomes of the D subgenome of hexaploid wheat. In this approach, seeds of hexaploid wheat (AABBDD) are irradiated and the surviving plants are crossed to tetraploid wheat (AABB) to produce a mapping panel based on quasi-pentaploids (AABBD). Chromosome lesions in the A and B genomes are largely masked in the quasi-pentaploids due to the presence of A- and B-genome chromosomes from the tetraploid parent. On the other hand, the chromosomes from the D-genome are present in one copy (hemizygous) and allow radiation hybrid mapping of all D-genome chromosomes simultaneously. Our analyses showed that transmission of D-genome chromosomes was apparently normal and that radiation-induced chromosome breakage along D-genome chromosomes was homogeneous. Chromosome breakage levels between D-genome chromosomes were comparable except for chromosome 6D which suffered greater chromosome breakage. These results demonstrate the feasibility of constructing D-genome radiation hybrids (DGRHs) in wheat.

An evaluation of the referral transport system of Patna, Bihar.

OBJECTIVES: The key objective of the study was to evaluate the coverage and functioning of the referral transport system under NRHM in block PHCs of district Patna in Bihar. METHODS: A cross-sectional descriptive study was conducted during October-November, 2008 in 16 block PHCs in Patna. In-depth interviews were conducted at 811 households where there was an occasion to transfer a patient to a hospital in the previous two months time. Medical officer in-charge and civil surgeon of the district were also interviewed. Besides, focus group discussions were conducted with the community members and leaders regarding the functioning of referral transport. RESULTS: Availability of the referral transport services was irregular mainly due to deputation of the vehicles for flood relief activities or other purposes. 93 (11.5%) of respondents used the PHC transport facilities, of which 52.7% got it instantaneously. 'Dial an ambulance 102' services were mainly used by urban clients. The system was following an arbitrary cost structure. 84.2% of the clients belonging to below poverty line had to pay for the service and are afraid of availing the services. CONCLUSION: Inadequate number of ambulances in PHCs, unequipped ambulances, lack of life saving equipments, 24 hours duty by single driver, arbitrary cost frame work and urban preference for services were some of the factors leading to unpopularity of the scheme.

An assessment of functioning of mobile medical units in Jharkhand.

BACKGROUND & OBJECTIVE: A scheme of Mobile Medical Units (MMUs) has been initiated under NRHM in Jharkhand state from the year 2008 in an effort to take healthcare to doorstep of the public in rural areas, especially in underserved areas. The objective of the study was to assess the functioning of Medical Mobile Units in Jharkhand through rapid assessment mode. METHODS: A cross sectional descriptive study was conducted in three selected districts of Jharkhand state during September-December 2008. Data was collected through in-depth interview using semistructured schedules with State Programme Managers, Chief Medical Officers, District programme managers, staff of MMU and beneficiaries. RESULTS: The scheme provided curative and diagnostic facilities like X-ray, ultra sound, and blood test to the poor and under-served areas. More than 90% of clients reported availability of medicines in MMUs. However, more than 90% of them had no prior information about the day and time of visits by the MMUs. Some of the operational difficulties being faced by the scheme were reported to be vibrations of generator disturbing the lab investigations, poor condition of the road, unwillingness of doctors to go in far-off areas and heavy workload. CONCLUSION: The scheme of MMUs has been successful in providing health services to the poor and under-served areas.

Assessment of utilization of RCH services and client satisfaction at different level of health facilities in Varanasi District.

OBJECTIVE: To assess the various factors influencing utilization and non-utilization of RCH services and extent of client satisfaction. METHODS: A cross-sectional study was conducted during October to December 2008 at two selected blocks of Varanasi district, Uttar Pradesh. Principal study subjects were 509 women having children less than 12 months old, selected through a multistage sampling technique. Data were collected through in-depth interview and Focus Group Discussions conducted among the beneficiaries of the services. RESULTS: The study revealed that utilisation of the RCH services in the government facilities was higher among the backward classes than the general category; higher the level of education the lower was the utilisation of government services. Over all, 16% of the respondents were not satisfied with government facilities. 25% of the SC category was not satisfied with the services in spite of being the main users. Among RCH services utilization was highest (89%) for antenatal care services (ANC). 41.6% respondents did not receive any Post Natal Care (PNC) after their most recent birth. About 30% deliveries were at home out of which only 10% received PNC whereas out of 70% institutional deliveries about 80% received PNC. Overall 16.3 % of the respondents were not satisfied with the services provided by government health facilities. Around 16% and 14% were not satisfied with the behavior of medical officer and the health workers respectively and non-satisfaction was highest among SC category. CONCLUSION: All health facilities need to be made functional according to Indian Public Health Standards (IPHS) of NRHM.