The voluntary community health movement in India: A strengths,weaknesses, opportunities,and threats (SWOT) analysis

There has been a prolific growth of voluntary organizations in India since independence in 1947. One of the major areas of this growth has been in the field of community health. The purpose of this article is to historically trace the voluntary movement in community health in India, analyze the current status, and predict future trends of voluntary efforts. A review of the literature in the form of a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was the method of this study. Some of the key trends which emerged as the priority areas for progress and for strengthening voluntary organizations in the future were enhancing linkages between health and development; building upon collective force; greater utilization of participatory training; establishing egalitarian and effectual linkages for decision making at the international level; developing self-reliant community-based models; and the need for attaining holistic empowerment at individual, organizational, and community levels through duty consciousness as opposed to merely asking for rights.The authors would like to express gratitude to Voluntary Health Association of India for sharing the necessary documents and to Dr. Rick Petosa for valuable editorial comments.     

Seasonal variation of alkaloids of Adhatoda vasica and detection of glycosides and N-Oxides of vasicine and vasicinone

The distribution pattern of the alkaloids of A. Vasica has been studied with change of season. The study also resulted in the detection of glycosides and N-oxides of vasicine and vasicinone.     

Predicting low birth weight delivery using maternal nutritional and uterine parameters

At the Institute of Medical Sciences, Banaras Hindu University in Varanasi, India, health workers took anthropometric measurements and hemoglobin level of 196 pregnant women at gestation of 37-41 weeks and of their singleton newborns to detect a combination of maternal nutritional and uterine parameters which could be used to screen mothers at high risk of delivering a low birth weight (LBW) infant ( 2500 g). The maternal anthropometric measurements included pre- and post-delivery weight, height, head and midarm circumference, fundal height, and abdominal girth. Weight, height, head and midarm circumference, and hemoglobin were significantly correlated with birth weight. Pre-delivery weight was better correlated than post-delivery weight with birth weight (r value = 0.4966 vs. 0.3494). The correlation between pre-delivery weight and birth weight remained, even when hemoglobin and one of the uterine parameters were controlled simultaneously. Hemoglobin was an independent significant predictor of birth weight, when all other variables were controlled simultaneously. Both fundal height and abdominal girth were significantly associated with birth weight, when all other variables were controlled simultaneously. Fundal height had a greater difference in means of birth weight than did abdominal girth (960 vs. 871 g). If the fundal height was less than 25 cm, all infants had a LBW. If the fundal height was greater than 35 cm, only one infant had a LBW. The multiple regression equation using pre-delivery weight, hemoglobin, fundal height, and abdominal girth (all independent significant parameters) to estimate birth weight accounted for 70.5% variation. Researchers tested the equation on 118 consecutive full-term singleton newborns. The equation predicted LBW in 32 of the 36 actual LBW deliveries. The estimated birth weights in the 4 actual but missed cases were 2620, 2600, 2566, and 2826 g. This equation can be successfully used to screen pregnant women for LBW.     

Infrared thermometry of newborn infants

An infrared thermometer, the FirstTemp, was tested among newborn infants by comparing tympanic membrane temperature measurements in three operating modes, "Cal-tympanic," "Cal-surface," and "Cor-tympanic," with nearly simultaneous tympanic membrane, rectal, and axillary temperature measurements using other standard methods. The FirstTemp underestimated other measurements of body temperature in the "Cal-tympanic" mode and overestimated them in the "Cor-tympanic" mode. In the "Cal-surface" mode, the First-Temp readings were significantly lower than tympanic membrane temperatures measured with a thermistor probe and electronic thermometer (mean difference 0.2 degrees C) but not significantly different from rectal or axillary temperatures. According to these results, the FirstTemp can be used reliably in the "Cal-surface" mode but not in the "Cal-tympanic" or "Cor-tympanic" mode. Its speed and ease of operation offer significant advantages over traditional clinical methods of temperature measurement.     

Factors affecting mechanism and kinetics of drug release from matrix-based oral controlled drug delivery systems

Matrix technologies have often proven popular among the oral controlled drug delivery technologies because of their simplicity, ease in manufacturing, high level of reproducibility, stability of the raw materials and dosage form, and ease of scale-up and process validation. Technological advancements in the area of matrix formulation have made controlled-release product development much easier than before, and improved upon the feasibility of delivering a wide variety of drugs with different physicochemical and biopharmaceutical properties. This is reflected by the large number of patents filed each year and by the commercial success of a number of novel drug delivery systems based on matrix technologies. Matrix-based delivery technologies have steadily matured from delivering drugs by first-order or square-root-of-time release kinetics to much more complex and customized release patterns. In order to achieve linear or zero-order release, various strategies that seek to manipulate tablet geometry, polymer variables, and formulation aspects have been applied. Various drug, polymer, and formulation-related factors, which influence the in situ formation of a polymeric gel layer/drug depletion zone and its characteristics as a function of time, determine the drug release from matrix systems. Various mathematical models, ranging from simple empirical or semi-empirical (Higuchi equation, Power law) to more complex mechanistic theories that consider diffusion, swelling, and dissolution processes simultaneously, have been developed to describe the mass transport processes involved in matrix-based drug release. Careful selection of an appropriate model for drug release provides insight to the underlying mass transport mechanisms and helps in predicting the effect of the device design parameters on the resulting drug-release rate. Thus, a basic understanding of release kinetics and appropriate mechanisms of drug release from matrix system and their inter-relationships may minimize the number of trials in final optimization, thereby improving formulation development processes.     

Family history of cancer and autoimmune disease and risk of leukemia in infancy: a report from the Children's Cancer Group (United States and Canada)

Objectives: As there are some suggestions that a family history of cancer or autoimmune disease might be associated with an increased risk of leukemia in children, we explored this possibility using data from a matched case-control study conducted by the Children's Cancer Group. Methods: We compared the family history of cancer and autoimmune diseases of 302 infant leukemia cases (diagnosed within the first 18 months of life) with that of 668 individually matched controls in the United States and Canada. Results: Although not significant, cancer history in parents was found to be associated with an elevated risk of infant leukemia (odds ratio [OR] = 1.4, 95 percent confidence interval [CI] = 0.6-3.6), predominantly acute myeloid leukemia (AML) (OR = 2.2, CI = 0.6-9.0). Cancer history among second-degree relatives was also related to a non-significantly elevated risk of AML. Family history of autoimmune diseases, on the other hand, was generally not found to be related to the risk of infant leukemia. Conclusion: This study provided no strong evidence that family history of cancer or autoimmune disease is a major risk factor for infant leukemia.