Vol 1, Issue 1, Jan-Mar, 2011

poverty when microfinance programs are combined with increased access to basic social services, including health, than when the programs focus on credit alone. Studies have shown that illness and related expenditures are the leading cause for micro-business failures and loan default. This paper is an attempt to understand the health programs offered by MFIs in India, and build the case for wider integration of health into microfinance programs. A review of MFIs listed in the MIX Market database was done, followed by a search of individual MFI websites. One in every four MFIs in India offers some form of health services. These programs vary widely from small scale health awareness programs to complex health interventions. Health education is the most common health intervention by MFIs (58%), followed by health camps (24%), and health insurance (24%). 12% MFIs offer health loans in addition to the regular business loan. 38% of MFI-health programs attempts to address composite health needs of their clients. 11% of the MFIs addresses the issue of community hygiene and sanitation and nutrition, followed by awareness and control of HIV/AIDS, mother and child health, and immunization program (8%). Often MFIs struggle to design appropriate community sensitive health programs which can result in failures. Also the lack of evidence sharing in the sector, calls for more systematic efforts to strengthen evaluation and applied research.

Research question: What are the views and efforts for human resources utilization and development in civil hospital, Ahmedabad? Objectives: 1. T o study the existing human resources in the Civil Hospital, Ahmedabad. 2. T o study the opportunities and efforts to improve the human resources development in the Civil Hospital, Ahmedabad. 3. T o study the efforts to improve the utilisation of human resources to optimise the health care delivery by the hospital. Study Design: cross sectional study over the period of six months. Setting: Government Institutes - B.J.Medical Collage and Civil Hospital and in-campus single speciality hospitals, Ahmedabad. Participants: Employees working with B.J.Medical Collage and Civil Hospital, Ahmedabad. Statistical Analysis: Standard error of proportion (SEP) Study Variables: Utilisation, Development Results: This study shows conclusion that Technical persons working in these organisation are more concentrated in the group of 2–5 year of service and 6–10 years of service, i.e. 25.53%, these may be due to the reason that technical person have higher chances to go for higher studies, training, deputation or transfers with promotions. Among all technical employees about 87.23% of them have attended or taken the trainings based on Technical matters. 10.64% of technical employees have taken training on Administration, and 2.13% have taken on the subject of communication. Among all available employees in different departments of civil hospital about 27% believe that the organisational administration is obtaining more than 75% of their work efficiency. For improvement in their work performance these employees get different sources. About 29.79% of the technical employees get their updates from bulletins and reference books. About 17.02% get from Medical Association publication. About 51.06% get their updates from Internet surfing and only 2.13% get updated through their colleagues. This shows wide coverage of Internet surfing and use and awareness about globalisation of information and knowledge about medical services. Majority of the technical employees, i.e. 53.19% have shown interest for further training and development in the field of Machine, i.e. mechanisation of the treatment or care provision. 17.02% each have shown their interest in the field of Time management and its application and Inventory management. Only few have shown their interest for training in communication, i.e. 4.26% and Man-to-Man relationship (Interpersonal relations) i.e. 8.51%. Overall it’s the era of instrumentation and advancement of techniques of Information and technology in the field of medicine. Key words: Utilisation, Development, Human Resources

The recommended strategy for elimination of Lymphatic filariasis (LF) is single-dose, once-yearly mass treatment with anti-filarial drugs and the program is in operation on a national level in India.1 Envirornmental control being a long term measure, the most practical and feasible method of controlling LF is to rapidly reduce the microfilaria load in the community by annual mass drug administration (MDA) of a single dose of antifilarial drugs, i.e. of diethylcarbamazine (DEC) or ivermectin with or without albendazole; 5–10 rounds of treatment with 75%–80% compliance could possibly eliminate the disease by reducing transmission to very low levels.1,2,3,4,5,6 Rate of coverage and consumption is the most crucial factor in the success of Mass Drug Administration (MDA) program.7 In spite of massive efforts, the program demonstrated suboptimal coverage and consumption in urban areas than rural. In Orissa, urban areas recorded significantly lower levels of coverage and compliance due to a lack of separate urban MDA strategy.4 2002 MDA data from urban and rural areas in Orissa, India, showed 45% coverage in urban areas and 76% in rural areas Lack of awareness is one of the major reasons for poor compliance of drug during MDA.3

Escherichia coli are the commonest cause of community and nosocomial urinary tract infection (UTI). Antibiotic treatment is usually empirical relying on susceptibility data from local surveillance studies. We therefore set out to determine levels of resistance to 9 commonly used antimicrobial agents amongst all urinary isolates obtained over a 12 month period. Methods: Antimicrobial susceptibility to ampicillin, amoxicillin/clavulanate, cephalexin, cefpodoxime, norfloxacin, amikacin, nitrofurantoin, trimethoprim and imipenem was determined for 14,678 E. coli urinary isolates obtained from community and hospitalised patients in Chennai, South India. Results: Imipenem was the most active agent (100% susceptible), followed by nitrofurantoin and amikacin (94% each). High rates of resistance to ampicillin (82%) and co-trimoxazole (76%), often in combination with norfloxacin were observed in both sets of isolates. Although 65% of the isolates exhibited resistance to multiple drug classes, resistance to cefpodoxime, indicative of extended spectrum β-lactamase production, was observed in 40% of community and 60% of nosocomial isolates. Conclusion: With the exception of nitrofurantoin, resistance to agents commonly used as empirical oral treatments for UTI was extremely high. Levels of resistance to trimethoprim and ampicillin render them unsuitable for empirical use. Continued surveillance and investigation of other oral agents for treatment of UTI in the community is required.

Context: Psoriasis is a common non-contagious chronic inflammatory skin disorder characterized by patchy inflammatory lesion covered with silvery white scales. Its etiology is still unknown while genetic, metabolic and immunological mechanisms have been recommended as its cause. An increased ratio of triglycerides to HDL-cholesterol (TG/HDL-c) is considered a risk for the development of coronary heart disease is reported by several studies. Excessive shedding of scales from the skin in the course of disease causes loss of proteins. Objective: To estimate and compare atherogenic index in psoriatic patients and controls and to analyze the electrophoretic pattern of serum protein fractions in psoriatic patients and controls. Materials and methods: 50 patients with psoriasis of various degrees of severity and 50 age and gender matched non psoriatic subjects were included in the study. Serum lipid profile and serum total proteins and protein fractions was determined. Statistical analysis was done using SPSS software. Results: Atherogenic index showed statistically significant increase in psoriatic patients compared to normal individuals (p < 0.05). The mean serum total proteins showed statistically significant decrease due to decrease in albumin.However, the protein fractions showed statistically significant increase due to increase in α2 , β and γ globulins in psoriatic patients compared to normal individuals (p < 0.05). Conclusions: Meticulous follow up of dyslipidemia and protein levels with adequate protein supplementation throughout the course of the disease can go a long way in improving patient’s nutritional status and also can prevent the complications associated with hyperlipidemia and hypoproteinemia. Key words: psoriasis, atherogenic index, protein fractionation.

Objectives: To study the knowledge and practice of handwashing after critical moments among mothers of under five children and to recommend measures for improvement of handwashing practices based on the study findings Methods: A community based cross-sectional study was undertaken during February 2010 covering 28 villages around coastal South India. The EPI 30-cluster sampling method was used and 1898 mothers of under five children were interviewed about their knowledge and practice regarding handwashing after critical moments. Results: 83.41% mothers stated handwashing was important for prevention of communicable diseases. 77.82% opined that washing hands with only water was sufficient. 38.88% and 24.92% stated handwashing could prevent diarrhoea and ARI respectively. 80.08% mothers thought handwashing was crucial before eating meals; 56.90%, 41.73% and 40.73% respectively felt that it was important to wash hands after defeacation, before preparing food and feeding child. 73.18% mothers washed hands with soap and water after defeacation and 63.91% after cleaning the child who had defeacated. Majority wash their hands with only water before preparing food (71.86%) and feeding the child (67.39%). Mothers with per capita monthly family income of Rs.1001-2000 and more, education of 5-7 standard and above, belonging to a joint family and Christian background had better handwashing practices. However, daily labourer mothers were at highest risk of not washing hands at all critical moments. Conclusion: Knowledge and practice of handwashing is low among rural mothers. Hence there is a need to spread importance of proper and regular handwashing in rural areas through available evidence based BCC strategies and multiple dissemination channels. Key words: Coastal South India, handwashing, mothers, under five children

Hypertension is one of the common complications met with in pregnancy and contributes significantly to the cause of maternal and perinatal morbidity and mortality. The study of uric acid in serum is an interesting problem especially in normal pregnancy and pregnancy induced hypertension (PIH). The present study was carried out at Physiology Department, Shri M. P. Shah Medical College and Guru Gobind Singh Hospital, Jamnagar on Total 80 subjects. Determination of uric acid was carried out by quantitative estimation on colorimetric method by enzymatic uricase method. Results shows that Serum uric acid levels in both the time (predelivery and postdelivery) were statistically significant in Pregnancy induced hypertension than normal pregnancy. Many patients had predisposing factor to development of preeclampsia like primigravida. It is also evident that severity of proteinuria increases with diastolic blood pressure and Levels of serum uric acid did show a high positive correlation with the severity of Pregnancy induced hypertension in relation to hypertension and proteinuria 65% of patients of PIH Key words: Pregnancy, Hypertension, Uric Acid

Each year among 135 million new births in the world, about 3% are affected with major structural birth defects, called congenital abnormalities (CAs).1 At present the total group of CAs is the major cause of infant mortality and disabilities among children in the industrialized countries. Therefore, the prevention of CAs is an extremely important public health issue. Oral Facial Clefts (OFCs) are among the most common birth defects with varying birth prevalence rates among populations, gender, and geographic region, occurring in 1-2/1000 live births.2 Its pathogenesis is multifactorial in that both genetic and lifestyle aspects such as nutrition are involved. Inadequate maternal nutrition during pregnancy has been suspected as a cause of oral clefts in humans since at least the early 1900s. In this respect, it is important to address that during pregnancy, specifically during the development of the lip and palate, the embryonic nutritional status is fully dependent on maternal food intake and metabolism. Due to increased needs, inadequate intake, decreased absorption, disturbances in embryonic transfer, or underlying genetic aberrations in the mother or embryo or both, maternal nutritional deficiencies during pregnancy may significantly affect the nutritional status of the embryo and gene expression and other developmental events in specific embryonic tissues.3

Infections in immunocompromised hosts warrant special attention. Normally existing as hospital contaminants, Sphingomonas paucimobilis can be a rare opportunistic human pathogen. We report one such case by this nonfermenting bacilli causing uncomplicated urinary tract infection in a renal transplant recipient patient with histoplasmosis of colon. Awareness about the posssiblity of the same is important. Infection control measures of the hospital needs to be stepped up with the isolation of such organisms to prevent cross-transmission and outbreaks. Key words: Sphingomonas paucimobilis, urinary tract infection, renal transplant, infection control.

Successful management and cure of gestational trophoblastic disease [GTD, molar ] depends upon prompt, accurate diagnosis and institution of individualized, therapeutic modalities. Because Molar pregnancies encompasses multitude of clinical entities, each with myriad presentations, clinicians must remain alert to identify patients exhibiting signs and symptoms consistent with GTD [molar]. Armed with a high index of suspicion, physicians may target such individuals and launch the appropriate diagnostic barrage, leading to triage for treatment early in the course of the disease. The disease if not diagnosed early may lead to complication such as, acute respiratory distress, cardiac failure, liver and renal failure. Intracranial bleeding and seizures complicated with infection and coagulation failure may lead to death of these young women. Little data are available to assist in the counselling of women with diagnosis and compulsory follow up. Appropriate contraception should be discussed and advise given before discharge as they may get lost to follow up. These women should be informed of the elevated risk of developing malignant sequlae in future. Keywords: Diagnosis, molar pregnancy, complication- haemorrhage [respiratory, cardiac, renal, hepatic, intracranial] intensive care, counselling and follow up.