Editorial

Editorial

Rabies is nearly 100% fatal and 100% preventable zoonotic disease. Rabies causes 50,000 deaths worldwide of which, more than 80% occur in India. Bite from any warm-blooded animal can transmit rabies. Management of animal bites from the point of view of prevention of rabies is a three-pronged policy: (a) Wound treatment, (b) antirabies serum and (c) antirabies vaccine (ARV). ARV can be given by both intradermal and intramuscular routes, however regimens, of both, are different. The minimum duration of re-exposure immunization is considered to be 3 months in a previously fully treated case of animal bite. There is also provision of preexposure prophylaxis in high-risk groups and children by both intramuscular and intradermal route.

OBJECTIVE: To study the effect of antenatal care services (ANC) during pregnancy on prevalence of anemia amongst pregnant women in Lucknow. STUDY DESIGN: Cross-sectional study. STUDY AREA: Urban and rural areas of Lucknow. STUDY SUBJECTS: A total of 420 pregnant women. RESULTS: More than half (65.2%) of the pregnant women registered their pregnancy at any health facility. The overall prevalence of anemia was 73.1%. Of these, the moderate anemia was 47.6%, mild was 43.6%, and severe was 8.8%. The prevalence of anemia was significantly lower (35%) in those who have received ANC services than who did not (RR = 0.65, 95% CI = 0.59-0.72, P < 0.0001) and this was not associated with the number of visits. The prevalence of anemia was significantly lower (65%) in those who have consumed 100 IFA tablets (RR = 0.35, 95% CI = 0.24-0.51, P < 0.0001). The prevalence was also significantly lower (53%) in those who have received two doses of TT injection (RR = 0.47, 95% CI = 0.39-0.56, P < 0.0001). The results of the multivariate analysis indicated that the components of ANC services were significantly associated with the prevalence of anemia when adjusted for socio-demographic characteristics. CONCLUSION: The ANC services well correlated with the prevalence of anemia so, it is to be promoted that every pregnant woman should get ANC services in time.

Microscopic polyangiitis presents in unique ways with systemic manifestations. The disease is seen classically in elderly population and has atypical presentation in children and adolescents. We present a case of young adult who presented with recurrent iron deficiency anemia because of microscopic polyangiitis. We present the case for obscure presentation of a rare disease with a common manifestation.

CONTEXT: Enough literature is not available on knowledge of the doctors regarding Consumer Protection Act (CPA). Lack of awareness of the treating doctors may make the entire hierarchy in the medical organization liable to the implications due to vicarious liabilities. AIM: A study was planned to benchmark the existing level of doctors’ knowledge regarding CPA in selected public and private sector medical organizations in Chandigarh. SETTING AND DESIGN: Hospital-based cross-sectional study. MATERIALS AND METHODS: A total of 440 doctors working in various government and private hospitals of Chandigarh were given a pretested self-administered questionnaire. The questionnaire consisted of 35 closed-ended questions of which 25 questions were for knowledge assessment and 10 questions were for assessing the perceptions of the doctors on the implications of the act. STATISTICAL ANALYSIS: All the 25 knowledge questions were scored. Data analysis was done to describe the sub-group mean scores in univariate and multivariate analysis. RESULTS: The mean knowledge score of the respondents was 15.83 (range 4-24). It was 63.3% of the total achievable score. On multivariate analysis, keeping institution, designation, educational qualification, and sex as predictors in the model, private institution, associate professors, assistant professors, and medical officers scored significantly better independently than the others in the model. Some important observations with respect to perceptions of the doctors about implications of the act have been described in the paper. CONCLUSIONS: Knowledge of doctors about many aspects of CPA is not satisfactory. Practicing government and private doctors have better knowledge than the academicians. Regular planned teaching and training programs are required to keep the doctors updated about CPA.

BACKGROUND: People of border areas are socio-economically underdeveloped and medically underserved. Anemia in the growing phase of life impairs the physical and cognitive functions and in turn, hampers the overall development of the country. OBJECTIVE(S): To find out the prevalence, socio-demographic correlates, and risk factors of anemia among adolescents residing in a border area. MATERIALS AND METHODS: A community-based descriptive cross-sectional study was carried out among 370 adolescents selected randomly by multistage and 30-clusters random sampling method. Data pertaining to the socio-demographic factors, life style and diet pattern, relevant health problems, and care-seeking were collected by a pre-designed schedule. Venous blood was examined by cyanmethemoglobin method to assess the Hemoglobin level. RESULTS: The overall prevalence of anemia was revealed to be 83.78% with a significant female predilection (92.59% vs. 76.92%, ?2 = 16.46 at degree of freedom = 1, P < 0.05; odds ratio (OR) = 3. 75, 95% confidence interval (CI) = 1.84-7.77). The prevalence was higher among early adolescents compared with mid- and late-adolescents (?2 (overall) = 9.14, at df=2, P = 0.0103) but significant female preponderance was found in the last group with ?2 = 12.5, df = 1, P < 0.05; OR(CI) = 4.29 (1.73-11.02). Anemia was revealed to be associated with lower literacy and socio-economic status (P < 0.05), bare-foot walking (P < 0.05), open-field defecation (P < 0.05), worm-infestation (P < 0.05), and care-seeking from unauthorized medical practitioners (P < 0.05) . CONCLUSION: Strict implementation of the National Anemia Control Programme as a component of school health and other health services through sub-centers and Anganwadi Centers is the need of the moment to chain the anemia.

The Physician Assistant (PA) plays a very important role in the rural areas manning clinics and health centers where no doctor is available. Millennium development goal (MDG 4) is targeted at reducing under-five mortality rates by half between 1990 and 2015. However, the current rate of 80 deaths per 1000 live births is far greater than the target rate of 40 per 1000 by 2015. MDG5 is aimed at reducing maternal mortality ratio by 2/3 by 2015. However, the current trend shows maternal death of 451 per 10,000 live births as against 185 by 1000 live births. MDG6 aims at combating HIV/AIDS, malaria, and other diseases such as tuberculosis, diabetes mellitus, and hypertension. There is still the need to reduce the prevalence of these diseases. Therefore, there is a need to increase the knowledge and number of PAs in the rural areas to help solve these problems.

ACKGROUND: From 1995 to 2007, age-standardized total cancer mortality rates in the North Cyprus (NC) fell by around 9% in both sexes. Available cancer mortality data in Europe up to 2002 allow a first check of the forecast of further declines in cancer mortality. MATERIALS AND METHODS: We considered trends in age-standardized mortality from major cancer sites in the NC during the period 1995-2007. RESULTS: In women, total cancer mortality declined by 23% from 92/100 000 to 75/100 000 between the years 1995-2007. Corresponding figures for men were 85/100 000 to 66/100 000, corresponding to falls of 23% from 1995 to 2007. Lung cancer in men declined from 20/100 000 around 1995 to 16 around 2007 (-20%). In women, lung cancer mortality was 2/100 000 and there were no changes between the years 1995 and 2007. Bladder cancer declined by 25% for both men and women from 1995 to 2007. Breast cancer mortality declined from 18/100 000 around 1995 to 15/100 000 (-16%) in 2007. Prostate cancer was approximately stable until 2000, but declined from 8 to 6 (-25%) in 2007. CONCLUSIONS: Despite the persisting rises in female lung cancer in the EU, the recent trends in cancer mortality in the NC are encouraging and indicate that a 9% reduction in total cancer mortality from 1995 to 2007 is realistic and possible.

BACKGROUND: A diagnostic reference levels (DRLs) form an efficient, concise, and powerful standard for optimizing the radiation protection of a patient. OBJECTIVES: To establish the first Ethiopian mammography diagnostic reference level (DRL) as a part of ongoing dose reduction program. MATERIALS AND METHODS: A cross-sectional study was conducted on breast patients having compressed breast thickness (CBT) between 3.7 cm to 5.3 cm in Addis Ababa, Ethiopia. Five mammographic units and 755 mammograms were included in the study period. The mean glandular dose (MGD) was assessed for standard size breast substituted by different polymethyl methacrylate (PMMA) phantoms and imaged under typical clinical conditions in two mammography units. Peak kilo voltage (kVp) and entrance surface air kerma (ESAK) were measured using calibrated digital dosimeter Mult-O-Meter Unfors, model 535L, Sweden. The data were analyzed statistically. RESULT: The 3rd quartile value of all mammography units and that of private mammography units were found to be 2.37 and 1.73 milligray (mGy), respectively. Hospitals 3rd quartile values of MGD ranges between 1.57 to 7.21 mGy. The MDG based on 4.0 cm polymethyl methacrylate (PMMA) measurements was found to be 1.5 mGy. CONCLUSION: Both phantom and patient dose values indicated unnecessary high doses in one government mammography unit. For this mammography unit, urgent dose-reduction measures and follow-up actions were recommended.