International Journal of Medicine and Public Health

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Online ISSN: 2230-8598
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Article
While T.b rhodesiense continues to spread from its traditional focus in the South and East, cases of T.b gambiense continue to be recorded in north-western Uganda in the West Nile Region. Of particular worry is that these foci are currently separated by fewer than 150 kilometers, much of which is inhabited by tsetse flies.1 Starkly contrasting with previous ambitious unsuccessful top-down, continent-wide eradication campaigns, Human African Trypanosomiasis (HAT ) control has now shifted from governmental to the individual level. In light of this imminent threat, the centre should remain sufficiently empowered to ensure provision of adequate technical expertise, as well as monitoring and evaluation. A literature review on HAT control activities in Uganda allowed for the identification of research gaps.
 
Demographic profi le 
Subtypes of ischemic strokes 
Percentage for risk factors 
Article
Background and Purpose: The purpose of this study was to determine the incidence and risk factor of ischemic stroke subtypes by a mechanism-based classification scheme (Trial of ORG 10172 in Acute Stroke Treatment [TOAST]). Materials and Methods: This study was conducted in Indraprastha Apollo Hospital, New Delhi, between 01/01/2004 and 31/12/2006. Out of 361 admitted stroke patients, 244 (67.59%) ischemic stroke patients were analyzed retrospectively for incidence and modifiable risk factors for stroke in our region. The cause of ischemic stroke was classified according to the TOAST criteria. Results: Out of 244 patients 165 (67.6%) were male and 79 (32.4%) were female, the mean age at the time of stroke was 57.1 years, the incidence of different risk factors were as follows: 139 (56.9%, odds ratio 2.71) hypertensive, 85 (34.8%, odds ratio 2.4) diabetics, 95 (38.9%, odds ratio 3.12) smokers, 58 (23.7%, odds ratio 5.34) dyslipidemics, 44 (18.0%, odds ratio 1.43) coronary artery disease (CAD) patients, 14 (5.7%, odds ratio 1.22) patients have the transient ischemic stroke in the past, 13 (5.3%, odds ratio 1.43) were given the history of atrial fibrillation. The incidence rates of ischemic stroke subtypes were as follows: Determined causes; large artery atherosclerosis 141 (57.7%), lacunes 18 (7.7%), cardio-embolism 11 (4.5%), hypercoagulable state 8 (3.2%), un-determined causes; atherosclerosis and/or lacunes 25 (10.2%), embolism and/or two more (hypercoagulable state/CAD) possible causes 7 (2.8%), negative evaluation in 34 (13.9%) patients. Ischemic stroke subtype according to the TOAST criteria was a significant predictor for long-term survival. Conclusions: Our data indicate that large vessel disease is a major cause, and the hypertension, diabetes, smoking, hyperlipidemia are the most common risk factors for Ischemic stroke.
 
Article
Introduction: Under-nutrition contributes to more than one-third of all deaths in children. It does this by diminishing children's immunity and making illness more dangerous. The primary aim of the study is to assess the nutritional status of children aged from 0 to 14 years in a slum area of Kolkata and secondary aim is to determine the prevalence of under-nutrition and its association with various risk factors among the study population. Materials and Methods: Community-based cross-sectional analytical study was carried out in urban slum of Chetla, Kolkata involving children of age group (0-14 years) from February to May 2012. All children (120) were examined clinically; their anthropometric measurements such as weight, height, mid upper arm circumference (MUAC) were taken using the standard operating procedures, after obtaining verbal consent from their parents with the help of a predesigned and pre-tested schedule. The anthropometric data was analyzed using World Health Organization Anthro and Anthro Plus Softwares. Results: The overall prevalence of under-nutrition among the study population was found to be 54 (45%). Among infants 9 (25%) were underweight, 3 (8.3%) were stunted, 22 (61.1%) were wasted and 23 (63.9%) showed thinness. Among 1-5 years aged children, 18 (30.5%) were underweight, 17 (28.8%) were stunted, 17 (28.8%) were wasted, 12 (20.3%) had MUAC 12.5-13.5 cm and 17 (28.8%) showed thinness. Among 5-14 years aged children, 11 (44%) were underweight, 10 (40%) were stunted and 12 (48%) showed thinness. Conclusion: The nutritional status of children in Chetla slum is not satisfactory in spite of proper immunization coverage and institutional deliveries. Special emphasis should be given for promotion of nutritional education to the mothers.
 
Article
Background: Retinopathy of prematurity (ROP) is a disease related to low birth weight, prematurity, oxygen administration, and various other factors, which are yet to be identified. Aims: The aim was to find incidence of ROP and risk factors for causation in babies weighing
 
Anthropometric statistics of the samples
Article
Aim: The aim was to identify the risk factors in developing metabolic syndrome among boys and girls aged 18-24 years in Mumbai city. Materials and Methods: A total of 200 samples were taken from different areas of Mumbai city. A lifestyle questionnaire was given containing questions like personal background and anthropometric measurements such as weight, height, body mass index (BMI), waist circumference and neck circumference were noted. Results and Discussions: The mean anthropometric measurements of 200 samples (100 boys and 100 girls) are as follows the mean age of the males in the study was found to be 21.26 ± 0.204 years and of females 21.31 ± 0.206 years. The mean differences in weight, height, and ideal body weight between males and females are as follows 75.3 ± 0.848 kg and 63.7 ± 0.735 kg, 171.37 ± 0.577 cm and 159.88 ± 0.552 cm, 71.39 ± 0.577 kg and 54.94 ± 0.544 kg. The mean waist circumference and neck circumference are as follows 87.88 ± 0.526 cm for males and 87.09 ± 0.559 cm for females and 37 ± 0.432 cm for males and 33.8 ± 0.456 cm for females. Conclusion: From the results, it can be concluded that BMI, neck circumference and waist circumference values are very higher than that of normal and this proves a basis that anthropometric measurements can be used to predict metabolic syndrome among young adults aged 18-24 years in Mumbai city.
 
Article
Context: To maintain high level of proficiency and better patient outcomes, medical personnel suffer from high degree of stress. The aim of this study was to determine the prevalence of stress and associated coping strategies among medical undergraduate students in a south Indian medical college. Settings and Design: Cross-sectional study was done among 1st year students in a private medical college in Tamil Nadu, India. A self-administered pretested questionnaire was used to collect socio-demographic information and information on perceived mental stress (PSS-10) and coping strategies (Brief COPE). Results: About 80% of the boys and 75% of the girls reported a moderate or higher stress level according to the PSS. Most commonly employed coping mechanism among students under stress was religion (25%). Among boys, the most common mechanism was humor (26%) and that of girls was religious methods (30%). Conclusions: Stress was common among first year medical students. There is a requirement for stress management training among MBBS students.
 
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Subject-wise break-up of Indian publications in cataract research during 2002-2011 
Article
Analyses the 1293 Indian publications in cataract research during 2002-2011, with a focus on contribution and citation impact of 15 most productive countries, India's overall contribution, its growth, citation impact, the share of international collaborative papers, identification of significant countries in India's international collaboration, different types of cataract research, analyses of research by sub-fields and different population age groups, productivity, and impact of leading Indian institutions and authors and pattern of communication of Indian output in most productive journals. The Scopus Citation Database has been used to retrieve the data for 10 years (2002-2011). Indian publications increased from 87 papers in 2002 to 195 papers in 2011, witnessing an annual average growth rate of 10.03%, registering an average citation impact per paper of 3.26 and international collaborative share of 21.58% during 2002-2011. Suggest that the government should encourage the decision makers and ophthalmologists and allied persons involved in ophthalmic services to make serious efforts in reducing the burden of cataract disease by increasing the R&D, strengthening of national and international collaboration and improve the existing training programs for ophthalmologic professionals.
 
Productivity and citation impact of top fi fteen Indian institutions in dengue research 
Article
The present study quantitatively analyze Indian dengue research output during the 10 years from 2003 to 2012, using Scopus international multidisciplinary database. The study focused on global publication output, share, rank, and citation impact of top 15 most productive nations, India's publications output, growth, global publication share and research impact, international collaborative papers share in national output and the share of major international collaborative partner countries in total India's international collaborative papers, contribution of various sub-fields and distribution by population age groups, productivity and citation impact of its leading Indian institutions and authors and Indian contribution in most productive journals. Indian contribution in dengue fever research consisted of 910 papers, which increased from 27 papers in 2003 to 193 papers in 2012, witnessing an annual average growth rate of 28.19%.Among the top 15 most productive countries, India holds second position in dengue fever research output, with global publication share of 10.22% during 2003-12. The average citation per paper scored by India was 3.27, the least among the top 15 most productive countries during 2003-12. India's share of international collaborative papers was 10.55% during 2003-12, which increased from 9.12% during 2003-07 to 11.13% during 2008-12. The present India's research efforts in dengue research are low in view of the 50,222 cases of dengue in 2012 alone. The country needs to increase its research output and also increase its research impact substantially particularly through enhanced national and international collaboration, besides evolving a national policy for identification, monitoring and control of dengue cases and also evolving a research strategy with sufficient funding commitment to solve this growing national problem.
 
Article
This paper analyzes 1078 India′s publications on suicide research during 10 years, i.e., 2005-2014, as indexed in Scopus International Multidisciplinary Database. The study focuses on the various aspects of performance of India′s suicide research, such as the publication growth, citation impact, international collaboration, subject-wise distribution of publications, contribution and citation impact of Indian organizations and authors, medium of communication, and characteristics of its high-cited papers. This study reveals that India′s research output on suicides research witnessed an annual average growth rate of 10.49%, registered an average citation impact per paper of 9.75, and a share of 16.23% of international collaborative publications. India′s global publication and share to world suicide research was 2.47% during 1999-2014. Medicine contributed the largest publication share of 84.32%, followed by pharmacology, toxicology, and pharmaceutics and social sciences (19.94%), environment science (9.37%), biochemistry, genetics and molecular biology (8.35% share), psychology (7.05% share), neuroscience (4.36% share), economics, econometrics, and finance (2.23% share), and immunology and microbiology (1.95% share) during 2005-2014. About 294 organizations and 356 authors participated in 1078 Indian papers in suicide research, of which the top 15 most productive Indian organizations and authors together contributed 36.18% and 17.44% publications share and 49.58% and 56.06% citation share to the India′s publications and citation output on suicide research during 2005-2014. This study also suggests the need for taking up of measures at population, sub-population, and individual levels to prevent suicide and suicide attempts. Suicide is a complex issue and therefore suicide prevention efforts require coordination and collaboration among multiple sectors of society.
 
Article
Meningococcal disease is a low endemic infection in Delhi and its outbreaks re-emerge in irregular cyclical fashion. The morbidity and mortality due to it, is not reflective of the population level disease burden as most of the data is based on reports from the different hospitals of Delhi. The reported data was analyzed for the period 2006-2010 from public and private hospitals located in Delhi. The aggregate caseload has reduced markedly over five years period since 2006 though the case fatality rate was comparatively higher in 2009 (16.8%). Maximum cases occurred in males of the agegroup 10-45 years. The Central, South and West zones of Municipal Corporation of Delhi (MCD) have been most vulnerable and affected. The usual emergence period for cases is between November and December which continues till June with a peak in the month of March every year. There is a need to take pre-emptive prevention and control measures in the preceding months; in the high risk zones of Delhi at the outset of any imminent outbreak of the disease; along with strengthening of the surveillance.
 
Article
Background: Herpes simplex virus type 2 (HSV-2) infection is the primary cause of genital herpes worldwide and also has potential role in facilitating human immunodeficiency virus (HIV) transmission. Materials and Methods: In our analytical cross-sectional study we interviewed and collected serum samples from 91 HIV positive subjects coming to antiretroviral therapy center at a government hospital in Delhi, to determine the seroprevalence and relative prevalence of HSV-2 among subjects with specific risk attributes. The patients were interviewed using a structured questionnaire and their serum samples were tested for HSV-2 specific immunoglobulin G (IgG) antibodies. We compared prevalence of HSV-2 antibodies between exposed and unexposed; to demographic, socioeconomic, and behavioral variables. Results: Fifty-two (57.1%) male and 39 (42.9%) female HIV positive subjects participated in the study. Seroprevalence of HSV-2 was 48.4% (males: 51.9% and females: 43.6%). Only 4.5% had given current history of genital ulcer. Overall increasing number of lifetime sexual partners showed significant association with HSV-2 seropositivity (Chi-square for trend: 19.17; P = 0.00001). Among men sexual contact with commercial sex workers (prevalence ratio (PR) = 6.6; 95% confidence interval (CI) =1.76-24.83; P = 0.0002) and age at first sexual intercourse
 
Article
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
 
Article
During the H1N1 -2009 Infl uenza A pandemic, 96 pregnant and postpartum women confi rmed positive by nasopharyngeal swab polymerase chain reaction were managed at Al Wasl Hospital, a tertiary referral centre in Dubai between 3 rd august to 17 th December 2009.we studied the characteristics, immediate outcome and complications of these cases. Majority presented with high fever, headache and one or more respiratory symptoms. They were managed according to WHO guidelines. 49% women needed hospitalisation. Most had mild illness and recovered completely. One case had severe illness needing ICU admission, culminating in maternal death. We conclude that the effect of swine fl u in our cohort was mild. Co morbidity and delay in seeking treatment led to worsening disease .Vaccination with Pandemrix (single dose vaccine) is recommended for all pregnant women and their health providers if there is onset of a new wave of infection.
 
Article
The Union Finance Minister while presenting the Union Budget for 2011-12 on 28th February, announced to step up the plan allocations for Healthcare in 2011-12 by 20% to Rs. 26,760 crore as against Rs. 22,300 crore in the year 2010-11.1
 
Article
Public provisioning of quality health care to make available affordable and reliable health services constitutes the focal point of national health programs and policies. Significant progress has been achieved over the decades during the various 5-year plan periods. The present paper discusses the changes achieved in the key areas of health over the XI 5-year plan period and further proposals for important areas under the XII 5-year plans.
 
Article
Guillain—Barre syndrome (GBS) is the most common and severe acute paralytic polyradiculoneuropathy. Since its initial description by Guillain, Barre and Strohl in the year 1916 there has been a huge expansion in the knowledge of this potentially treatable disorder. 2016 marks the centenary year of GBS. It was conventionally described as an acute onset ascending pure motor demyelinating illness with areflexia. It has an annual incidence of 1/1000,000 across several studies. It can occur at any age with a slight male preponderance and with seasonal variations. However with ever growing knowledge in last 100 years the clinical spectrum under this umbrella has also expanded and several subtypes based on histopathology and neurophysiology have emerged. The various forms of GBS are Acute Inflammatory Demyelinating Polyneuropathy (AIDP), Acute Motor Axonal Neuropathy (AMAN), Acute Motor and Sensory Axonal Neuropathy (AMSAN), Miller Fisher Syndrome(MFS). AIDP is the more common in the western world while AMAN is more common in Asian subcontienent (in Japan and China). Other variants like pandysautonomia, pure ataxic GBS, pharyngeal- cervical-brachial GBS, bibrachial onset GBS and isolated bulbar palsy have also been described. Few cases may have retained reflexes, positive babinski sign, papilloedema and transient bladder involvement. Read more. . .
 
Article
Aims and Objectives: Adverse drug reaction (ADR) may infringe upon compliance, which compromises therapy outcomes in chronic diseases. Our study focused on pharmacovigilance in stigmatizing disease vitiligo, concern with improving disease management incorporating current medical knowledge. Materials and Methods: Therapies in 250 vitiligo cases were scrutinized over period of six months, examining consistency to consensus approach and profiling of the adverse effects. Results: Adverse drug effects occurred in fifth of localized and third of generalized vitiligo patients. Adherence to consensus line of therapy resulted significantly in less adverse effect incidence, and steroid overtreatment was major determinant of risk. Conclusion: Consistency of treatment to consensus approach based on disease extent is prudent to reduce adverse drug effects in vitiligo. Increased vigilance, due psycho-social address, and incorporation of safe and efficacious new immunomodulator drugs is emphasized for consideration toward improved current vitiligo management.
 
Article
Background: Anemia is a medical condition in which the red blood cells (RBCs) count and hemoglobin (Hb) are less than the normal range. The main causes of anemia are a decrease in RBCs, their destruction and decrease of Hb synthesis. A useful method for diagnosis and classification of anemias is based on the morphological appearance of RBCs on an ideal stained blood smear. The main terms used in such classification are normocytic normochromic, microcytic hypochromic and macrocytic anemia. Aim: The aim of this study is to determine the most common morphological pattern of anemia in Saudi anemic patients who were admitted at King Abdul-aziz Medical City-Riyadh. Materials and Methods: Retrospectively we evaluated the results of complete blood count (CBC) and peripheral blood picture (PBP) of all anemic patients attending during the year 2013 (from 1st January to 31st December). Results: Participants in this study included 150 patients (13 infants, 27 children, 12 youths, 52 adults and 46 old). The gender distribution showed 70 males and 80 females. The results of CBC and PBP showed that 113 (75.3%), 36 (24%) and 1 (0.7%) of the patients had normocytic normochromic, microcytic hypochromic and macrocytic pattern of anemia respectively. Conclusion:The normocytic normochromic pattern of anemia is highly frequent among this sample of Saudi patients while the macrocytic pattern of anemia is the lowest. According to gender groups microcytic hypochromic pattern of anemia is more common among females; malnutrition, increase of blood loss due to pregnancy or menstruation, and lack of iron absorption are the main causes, while the normocytic normochromic is highly frequent among males, which are mainly due to blood loss or chronic diseases.
 
Article
Blood group in 44 cases of A.F.B positive patients and 3476 non-tubercular normal persons were determined. A relatively increased incidence of A.F.B positive cases were observed in persons with O blood group and blood group B was observed as commonest group among north Bengalis.
 
Knowledge of the participants on various aspects of BMW management
Average knowledge scores among participants
Attitudes of participants on safe management of BMW
Medical Interns' Knowledge on BMW management pre-intervention versus post-intervention. (N = 80)
Article
Aims: 1) To assess and compare the knowledge and attitudes regarding biomedical waste (BMW) management in specialists, resident doctors, new medical interns, and final year nursing students. 2) To assess the effectiveness of a training program in changing the knowledge and attitudes regarding BMW management. Study Design: Stage 1-descriptive, Stage 2-quasi-experimental. Participants: Specialists, resident doctors, new medical interns, and final year nursing students. Setting: Tertiary hospital with attached medical college in Navi Mumbai. Data Collection tool: Pretested, precoded self-administered questionnaire. Intervention: Educational training program on BMW management, Period of Study: December 2010-March 2011. Statistical Analysis: Using software Statistical Package for Social Sciences (SPSS) version 20, chi-square, analysis of variance (ANOVA), Tukey's post hoc, and Z tests applied. Results: There was a statistically significant difference in the knowledge scores between the groups as determined by a one-way ANOVA test (F (3,226) = 11.098, P < 0.001). A Tukey's post hoc test revealed that the specialists (20.82 ± 5.121) knowledge scores were significantly higher as compared to resident doctors (16.96 ± 5.268), medical interns (18.44 ± 4.293), and nursing group (15.33 ± 5.144). The positive attitude towards safe management of BMW was not found to be significant. After the training program in the medical interns' a statistically significant increase in their knowledge on BMW management was seen. Conclusion: The knowledge and attitudes between the groups of healthcare personnel varied and was not found to be satisfactory. Training programs with periodical sensitization sessions on BMW management are recommended, especially focusing at the junior level.
 
Article
Context: Despite policies to make health care accessible to all, it is not universally accessible. Frequent evaluation of barriers to accessibility of health care services paves path for improvement. Hence, present study is undertaken to evaluate the factors and public health policies influencing health care access to rural people in Chittoor District, Andhra Pradesh, which can be interpolated for other regions. Aims: To assess knowledge, perceptions, availing of public health care services, barriers to health care access in Chittoor District, Andhra Pradesh. Settings and Design: Cross-sectional, hospital-based survey in the Government Maternity Hospital (GMH), Tirupati, a tertiary care center. Materials and Methods: Fifty women delivered normally in GMH through convenient sampling technique. Data collected on standardized pro forma as per IMS Institute of Healthcare Informatics. Statistical Analysis Used: Is done through MS Excel 2007, Epi Info 7 (of Centres for Disease Control and Prevention, Atlanta, USA) and frequencies were described. Results: Distance, waiting hours, societal responsibility, nature of the illness, presumed commercialization of Medicare system, attitudes of health care providers, and loss of wages were not barriers for accessing health care. Accredited Social Health Activist (ASHA) and availability of ambulance services made great improvements in health care accessibility. Absenteeism of health care providers is a problem. Conclusions: Expanding the ambulance services and ASHA network will be an effective measure for further accessibility to health care. Absenteeism of health care providers needs correction.
 
Article
Aims and Objectives: To determine efficacy of analgesia of Analgesic drugs +Interferential Therapy (IFT) or without IFT. Material and Methods: The 80 eligible patients (30 male, 50 female) of acute and chronic low back pain were assigned to 5 groups (Grp), i.e., Grp A, B, C, D and E. The Orthopedician prescribed tablet Xenodol (Aceclofenac 100mg + Paracetamol 500mg 1 BD for 7 days) for Grp A, tablet Patrol (Tramadol 37.5mg + Paracetamol 325mg) 1 BD for 7 days) for Grp B, IFT 25 - 100Hz application at lumbar region for 15 min daily for 7 days for Grp C, tablet Xenodol of same dose with IFT 25 - 100Hz application for 7 days for Grp D and tablet Patrol of same dose with IFT 25 - 100Hz application for 7 days for Grp E patients. Eligible patients pain were assessed twice, i.e., pre-treatment and post-treatment, by SF-LF-MPQ (Short Form-Long Form McGill Pain Questionnaire's Rating Index. Results: The post-treatment mean±SD was 1.3±0.9, 1.4±1.5, 1.6±0.85, 1±0.73, 0.93±1.16for Grp A, B, C, D and E respectively, while the pre-treatment pain intensity score mean±SD was 1.9±0.5, 2.4±1.1, 2.13±0.8, 2.25±0.9, 2.25±1.1 for Grp A,B,C,D,E respectively. The differences was statistically significant, i.e. (P < 0.05) 0.03856, 0.03601, 0.0002027, 0.002136 of Grp A, B, D, E respectively and insignificant, i.e. (P > 0.05) was 0.06603 for Grp C. Conclusion: Tablet Xenodol (Aceclofenac+Paracetamol) and tablet Patrol (Tramadol+Paracetamol)alone showed efficacy in pain reduction, while when the tablets Xenodol and tablet Patrol of same doses given with IFT 25 - 100Hz application at lumbar regionin Grp D and Grp E the pain reduction was highly significant than the medication alone groups, i.e., for Grp A, B, C.
 
Change in Knowledge of Mothers RegardingBreastFeedingPractices 
Article
Introduction: Yet, approximately 30% dwellers are internal migrants in India. Migrant is one who resides away from his/her native home due to variety of reasons. In Uttar Pradesh, these relatively immobile internal migrants generally comprise of Nomad, Brick kiln and Migratory construction workers. The present study was carried out with the objective of evaluating the achievements of first phase of Special Routine Immunization Week (SRI week) in terms of improvement of immunization status of a community of internal migrants in Lucknow. Materials and Methods: The study was a community-based observational, which undertook relatively immobile internal migrant communities attributed to local administration of Community Development Block, Sarojininagar, Lucknow. The study was conducted during 24-30 th April 2013, covering equal numbers of households (each 100) from the three type of communities selected randomly. An attempt of in-depth interview with the adult member was made to reveal the underlying issues of the study. Results: Of the three communities, migratory construction workers outnumbered in the literacy status (7.46%). The immunization coverage in all the three communities prior to the SRI week was 24.63% while post to the first phase of SRI week was 81.12%, thereby achieving immunization by 56.49%. The present study also showed no relation between vaccination achievement during SRI week and literacy status of different communities. Conclusions: There is a need of having such sessions at regular intervals repeatedly as well as conducting focused studies on these groups to identify the various factors which are responsible for poor immunization coverage and keep them in mind while planning such special immunization activities.
 
Article
Diabetes is leading cause for cardiovascular complication, drugs having cardioprotective and antihyperglycemic actions are constantly in search. Oral glucose elicits a three to four times higher peak insulin response compared with an equivalent dose of glucose, if infused intravenously. This is due to the reasons behind, the oral glucose causes a secretion of gut hormones, mainly the glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) which enhance the glucose-induced insulin release. In patients with type 2 diabetes mellitus (type 2 DM), glucose-induced insulin release is unsatisfactory or absent. Because of this type 2 DM patients are unable to adjust their insulin secretion as per the need exist. GLP-1 secretion (but not GIP secretion) is diminished in patients with type 2 diabetes. However, when the GLP-1 and GIP agonist are administered in patients with type 2 diabetes, they elicit insulin secretion resulting in lowering of blood glucose level. In addition to its insulin stimulatory effect, GLP-1 agonist also induces cardioprotective effects. It increases nuclear respiratory factor-2 (Nrf2) and heamoxigenase-1(Ho-1) in cell which have antioxidant and cardioprotective property. GLP-1 maintains islets integrity and reduces apoptotic cell death of human islet cells in culture. Improved understanding of the mechanism of action and clinical effects of incretin-based therapies would be useful in advancement of its appropriate use in clinical practices.
 
Top-cited authors
Jayakrishnan Thayyil
  • Calicut Medical College
Praween Agrawal
Sutapa Agrawal
  • Population Services International
Brij Mohan Gupta
  • National Institute of Science Technology & Development Studies (NISTADS) CSIR New Delhi
Anton Neville Isaacs
  • Monash University (Australia)