Comparison of nutritional and hydration status in patients undergoing twice and thrice-weekly hemodialysis: a silent drama in developing countries

International Urology and Nephrology - In low and middle- income countries, due to lack of financial resources, the number of patients receiving one or two hemodialysis (HD) sessions a week has...     

Effect of the mode of croscarmellose sodium incorporation on tablet dissolution and friability

A computer-optimized experimental design was used to study the effect of incorporating a "super disintegrant", croscarmellose sodium, intragranularly, extragranularly, or distributed equally between the two phases of a tablet in which a poorly soluble drug constituted at least 92.5% of the formulation. The results were analyzed by means of a general quadratic response surface model and suggest that tablets with the same total concentration of super disintegrant dissolve at a faster rate when the super disintegrant is included intragranularly. Tablet friability was not affected by the method of super disintegrant incorporation.     

Communicating health

Routine production of communication materials without paying attention to utilization, field test, and impact analysis is ineffective. The concept of information, education, and communication (IEC) should encompass voluntary activity of health education in a tradition of innovation. One seminal factor may be the communication technologies developed by the National Technology Missions. The missions were participatory by seeking solutions among communities and analyzing health issues from the perspective of those directly involved, rather than from the top down. The prime focus of the national drinking water mission was convenience, hence messages concentrating on health advantages were ignored. At this juncture, influencing health behavior required decentralization reflecting local cultures. Thus community-based partners became the foundation of a strategy of communicating safe water. As national strategies emerged in each of the technology missions, communication addressed advocacy of the need for political will, dissemination of technical information, and influencing patterns of behavior. Despite learning a new understanding, the danger exists that IEC remains just another label of mass communication with posters, advertisements, brochures, radio, and television. Decisions on contraceptive choice and use requires more than just accurate information; it requires the power to make such a decision. A new approach demands a priority for communication skills taking into account people's aspirations. The HIV-AIDS crisis underlines the urgency with which communication has to respond to health challenges. A series of experiments facilitated by the World Conservation Union helped build communication capabilities among environmental groups working in Latin America, Africa, and India. The International Reference Center on Water and Sanitation initiated pilot communication projects in West Africa for community health.     

Preventing syphilis: lessons from a survey of two inner-city communities in Houston, Texas.

To develop a relevant, community-based prevention campaign, the authors examined, using street-intercept interviews, syphilis-related knowledge, circulation of information, and screening and treatment practices among four hundred residents of two inner-city communities in Houston, Texas, where syphilis case rates exceed city, county, and national averages. Although awareness of syphilis was near universal, one-fourth of the respondents thought syphilis was incurable, and a large proportion confused syphilis with other sexually transmitted diseases (STDs), mentioning discharge and burning or itching in the genital area as symptoms. Almost four out of five respondents were aware of free treatment and screening facilities in the local area, yet, less than two of five expressed the intention to get tested within the next month. Only 22 percent had seen or heard anything about syphilis in the past twelve months. The resultant prevention campaign is discussed along with implications for the development of comprehensive STD prevention and control campaigns in similar poor and underserved communities.     

Nutritional status of pavement dweller children of Calcutta City

Pavement dwelling is likely to aggravate malnutrition among its residents due to extreme poverty, lack of dwelling and access to food and their exposure to polluted environment. Paucity of information about nutritional status of street children compared to that among urban slum dwellers, squatters or rural/tribal population is quite evident. The present study revealed the magnitude of Protein Energy Malnutrition (PEM) and few associated factors among a sample of 435 underfives belonging to pavement dweller families and selected randomly from clusters of such families, from each of the five geographical sectors of Calcutta city. Overall prevalence of PEM was found almost similar (about 70%) to that among other 'urban poor' children viz. slum dwellers etc., but about 16% of them were found severely undernourished (Grade III & V of IAP classification of PEM). About 35% and 70% of street dweller children had wasting and stunting respectively. Severe PEM (Grade III & IV) was more prevalent among 12-23 months old, girl child, those belonged to illiterate parents and housewife mothers rather than wage earners. It also did increase with increase of birth rate of decrease of birth interval.     

Relationship between corneal thickness and measured intraocular pressure in a general ophthalmology clinic

OBJECTIVE: To assess whether central corneal thickness (CCT) is a confounding factor in the classification of patients attending for glaucoma assessment in a district general hospital. DESIGN: Cross-sectional study by a single observer. PARTICIPANTS: Patients attending a general ophthalmic clinic: 235 clinically normal eyes, 52 eyes with normal-tension glaucoma (NTG), 335 eyes with primary open-angle glaucoma (POAG), 12 eyes with pseudoexfoliative glaucoma (PXE), 42 eyes with chronic angle closure glaucoma (CACG), and 232 glaucoma suspect (GS) eyes. INTERVENTION: Central corneal thickness was measured using ultrasonic pachymetry. MAIN OUTCOME MEASURE: Correlation of CCT and diagnosis. RESULTS: Mean CCT was 553.9 microm (95% confidence intervals [CI] for the mean, 549.0-558.8 microm) in the clinically normal eyes, 550.1 microm (95% CI, 546.6-553.7 microm) in the POAG eyes, 514.0 microm (95% CI, 504.8-523.3 microm) in the NTG eyes, 530.7 microm (95% CI, 511.2-550.1 microm) in the PXE eyes, 559.9 microm (95% CI, 546.8-573.0 microm) in the CACG eyes, and 579.5 microm (95% CI, 574.8-584.1 microm) in the GS eyes. The differences of mean CCT between the groups were highly significant (P< 0.001 analysis of variance). Eighty-five percent of eyes with NTG and only 36% of eyes with POAG had a mean CCT of 540 microm or less. Thirteen percent of eyes with POAG and 42% of GS eyes had a mean CCT greater than 585 microm. CONCLUSIONS: The CCT measurement is desirable in patients attending for glaucoma assessment in a district general hospital to avoid misclassification resulting from the relationship between CCT and tonometric pressure. Central corneal thickness alone is not an accurate predictor for the clinical diagnosis in this group of eyes. However, many eyes diagnosed as having NTG have thin corneas, which would tend to lower the tonometrically recorded intraocular pressure (IOP), so the finding of a less-than-normal thickness cornea introduces some doubt as to the diagnosis of NTG. For the GS eyes, most eyes had thick corneas, which would tend to increase the tonometrically recorded IOP. Thus, GS eyes with modest elevation of IOP and a thick cornea may be at low risk of progressing to POAG. Thus, many patients with "high IOPs" and a thick CCT do not necessarily have high IOPs and may not need to be followed as GS eyes.