Natl Med J India
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Background Malaria in pregnancy (MIP) is a major public health problem due to the vulnerability of pregnant women to infections, resulting in adverse maternal/foetal outcomes in endemic areas. Methods We did a field-based study to assess the burden of MIP (prevalence at the time of enrolment and follow-up) and to identify risk factors for MIP in the Birsa and Baihar blocks of district Balaghat in Madhya Pradesh, which have perennial malaria transmission. Malaria screening (during 2015-2017) was done by microscopy and bivalent rapid diagnostic test (SD Bioline RDT, malaria antigen Plasmodium falciparum/Plasmodium vivax Pf/Pv). ⋯ Pregnant women of the Baiga ethnic group were more likely to have malaria compared to those belonging to the Gond group (OR [95% CI]; 2.4 [1.7-3.4]; p<0.00001) and non-indigenous group (OR [95% CI]; 8.3 [3.9-19.7]; p<0.00001). Primigravid status of women, first and second trimester of pregnancy, women belonging to indigenous ethnic tribal group and cash crop insufficiency for whole year (a socioeconomic indicator) in the family were the independent risk factors for malaria. Conclusion MIP is a major public health problem in forested tribal settlements of Birsa and Baihar blocks of Balaghat district in Madhya Pradesh and requires immediate intervention.
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With the decline in HIV mortality, a concomitant increase in morbidity and death not directly related to HIV has been witnessed. Consequently, many countries especially low- and middle-income countries (LMICs) are now facing the dual burden of HIV and non-communicable diseases (NCDs). 2.3 million people living with HIV in India are at a higher risk of developing NCDs due to ageing, which can be attributed to the additional impact of long-standing HIV infection and the side-effects of antiretroviral therapy. ⋯ The health and wellness centres (HWCs) envisioned to provide an expanded range of preventive and curative services including that for chronic conditions may act as a window of opportunity for providing egalitarian and accessible primary care services to these individuals. The reasons for integrating HIV and NCD care are epidemiological overlap between these conditions and the similar strategies required for provision of healthcare services.
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Background The competency-based undergraduate medical curriculum has a number of new elements. Few authors have attempted to understand the students' viewpoints on the curriculum. We assessed undergraduate students perspectives and ratings about various elements after 2 years of implementation of the curriculum. ⋯ Integrated Teaching, Small Group Teaching and Assessments were viewed less positively (62.9%-75%) and Self-directed Learning received the lowest positive responses (57%-58%). For training as a doctor, the elements considered most valuable were Early Clinical Exposure (70.4%) and Community Health Visits (70.4%) while the least were Logbooks (35.5%) and Reflections (34.2%). Conclusions Students found Early Clinical Exposure and Community Health Visits the most valuable elements whereas Self-directed Learning, Logbooks and Reflections were rated as the least useful.
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This article discusses a brief history of the concept of Right to Health, the concepts of rights and duties and why both are important and how, in healthcare, one's duty is another's right. The Rajasthan Right to Health Bill, 2022 is analysed and the shortcomings and issues in the Act are discussed. ⋯ In addition, a brief introduction to a successful scheme, the Tamil Nadu Innuyir Kapom Thittam- Nammai Kaakum 48 Scheme, with a similar aim is given. The article concludes that though the Right to Health Act is a noble initiative and is a necessary one; the Act, in its current version, has serious shortcomings and needs to be corrected.
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Desmoid tumours of the brachial plexus are rare locally infiltrative aggressive, monoclonal, fibroblastic proliferations characterized by a variable and often unpredictable clinical course. Only 21 patients have been reported in the literature. We add another one, and report function-preserving surgery in a 34-year-old man with a desmoid tumour of the brachial plexus. ⋯ Histopathological examination showed findings consistent with desmoid tumour. A tailored multidisciplinary surgical approach, with the aim to preserve function over radiological clearance, is an acceptable treatment strategy in preserving patient's quality of life for such infiltrating desmoid tumours encasing the brachial plexus. Following surgery, observation and close radiological surveillance offer an optimal strategy without jeopardizing the quality of life.