AP Tops in crimes against women  


AP tops in crimes against women
Hyderabad, December 07 2008: HYDERABAD: At a time when Andhra Pradesh, and Hyderabad in particular, is attracting hundreds of women software professionals from all over the country, the state has earned the dubious distinction for crimes against the fair sex.The latest statistics of the National Crime Records Bureau (NCRB) for 2007 reveals a telling tale of increasing crimes against women in the state, much more than any other part of the country.Of the 1,85,312 crimes against women in the entire country in 2007, 24,738 cases, or 13.3 percent, were reported from Andhra Pradesh.Even more disturbing is the statistics pertaining to Hyderabad and its outskirts.A comparison of crimes against women in 35 cities across the country shows that Hyderabad stands second, next only to Delhi.While 4,331 cases (17.5 per cent) were registered in Delhi, Hyderabad came second with 1,931 cases (7.8 per cent).Vijayawada topped in the number of eve-teasing cases by accounting for 11.3 per cent of the total cases in the country."If the police is strict in dealing with the offenders, things would not have come to such a pass.One of the reasons why there are more crimes against women is that law enforcers do not deal with the offenders firmly," says G Sucharitha, joint director, gender programming, Centre for World Solidarity.Interestingly, Andhra Pradesh, which has 7.2 per cent of the country's population, has reported 13.3 per cent of cases of crimes against women while Uttar Pradesh, which has 16.6 per cent of the country's population, reported 11.3 per cent or 20,993 cases.According to NCRB figures, crimes against women in general in the country have been increasing every year.In 2003, there were 1,40,601 cases, in 2004 1,54,333 cases, in 2005 1,55,553 cases and in 2006 there were 1,64,765 cases.Another disturbing trend is that the rate of crime has increased against women.While the overall, rate of crimes against women increased marginally from 14.7 per cent in 2006 to 16.3 per cent in 2007, for Andhra Pradesh in particular, it has been bad.The crime rate against women increased by 30.3 in Andhra Pradesh, which is almost that of Tripura at 30.7 per cent which is at the top."Women in Andhra Pradesh feel unsafe because the government is also not sincere in ensuring their protection," said women's rights activist Noorjehan Siddiqui.What is also alarming is the number of torture cases in the state.Of the 75,930 cases registered in the country under section 498A IPC (dowry harassment), as many as 11,335 cases (14.9%) are from Andhra Pradesh.Only Tripura is slightly ahead with 15.7 per cent."There are two reasons why such cases are more in AP.There is an insatiable desire for dowry here.Even people who go abroad demand dowry," an IG in the CID said.That is not all.AP with 3,316 cases has the most number of sexual harassment cases in the country.This is 30.3 per cent of the total number of cases.Even in cases pertaining to the Indecent Representation of Women (Prohibition) Act, in Andhra Pradesh, the most number of cases have been registered.In all, 1005 cases were registered, which is 83.8 per cent of cases registered in the entire country.

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COMPARATIVE STUDY OF ELISA AND RAPID SEROLOGICAL TECHNIQUES FOR THE DIAGNOSIS OF DENGUE FEVER IN PAEDIATRIC CASES IN ANDHRA PRADESH
INTRODUCTION
Dengue fever is a mosquito-borne flavivirus infection of humans caused by four serologically distinct viruses (dengue virus 1, 2, 3, 4)4. Dengue and its severe manifestations, dengue hemorrhagic fever and dengue shock syndrome are the serious public health problems in the tropics4. Dengue is the most important mosquito borne disease in the world especially in the tropics, causing regular epidemics in these regions4.
In India, dengue virus infections have been frequently encountered in epidemic proportions in several states3. In southern India, the disease has been reported in Tamil Nadu3, Karnataka3, Andhra Pradesh3, and Kerala3. The most recent dengue fever outbreak in Andhra Pradesh was in 20065. A significant increase in the number of children being affected by dengue virus was observed in a study done at Vellore between 1999 and 20031. Dengue is a fast emerging health concern in South India1.
Diagnosis of dengue infection is easily and best accomplished by demonstrating specific IgM antibodies in the blood4. Conventionally, this is done by using an IgM capture ELISA, which has to be done in the laboratory and takes a few hours to complete4. A newer method that has emerged is a rapid immunochromatographic card test with which a bedside test can be done for both IgM and IgG antibodies in the serum4. While the ELISA test is known to be a standard test, the results of the rapid technique are not consistent2.
OBJECTIVES
The objective of this study is:
To compare the sensitivity of the rapid immunochromatographic test to the known sensitivity of the ELISA test in a paediatric tertiary care hospital in Andhra Pradesh.
MATERIALS AND METHODOLOGY
STUDY SETTING: The study will be conducted in a tertiary care hospital, Niloufer Hospital (Government) in Hyderabad, Andhra Pradesh.
STUDY PERIOD: The study will be done in a period of two months, May and June, 2009.
STUDY SAMPLE: Infants and children who are suspected to be suffering from dengue fever by their clinical presentation and laboratory parameters (such as platelet count)__.
SAMPLE SIZE: A study sample of a minimum of __ cases reporting to this hospital
METHOD: Blood samples will be collected from suspected patients of dengue fever. They will then be analyzed by ELISA technique and by rapid immunochromatographic technique. The sensitivity of the rapid test will then be compared to the ELISA test.
STATISTICAL ANALYSIS: Basic proportions and percentages.
IMPLICATIONS
The study will:
Indicate the sensitivity of a rapid immunochromatographic test compared to the standard ELISA test.
In the case that the rapid immunochromatographic test is found to be as sensitive as ELISA, the study will expedite the diagnosis of dengue of patients reporting to the tertiary health care center.

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HOW TO PREVENT CANCERS  


Today's children, tomorrow's world. Public Service Announcement (30 sec)Many people around the world believe that cancer is fate - just something that happens to them if they are unlucky. They believe that they have no control over their chances of developing a cancer.In fact, more than one-third of all cancer cases worldwide - almost four million cases each year - can be prevented if we act on what we already know and apply that knowledge in our daily behaviour.Simple changes in lifestyle can reduce the risk of cancer.Tobacco use, diet, nutrition and exercise, and sun safety all play a role in influencing cancer risk. It is also possible to vaccinate children or young people against common viruses that cause specific cancers (liver and cervix).The aim of the "Today's children, tomorrow's world" campaign is to scale up awareness of what we can do to prevent cancer and to change people's behaviour in that light.Healthy habits established early in life have a significant impact in later years. Behaviour is already formed before adolescence. The environment in which children grow up - at home, in school, and in the community - powerfully influences their behaviour later on, whether this regards tobacco use and exposure to second-hand smoke, diet and physical activity, or smart behaviour in the sun. Policymakers' decisions about cancer vaccination at an early age determine how far children and young people will be protected against cancers of the liver or cervix. For all these reasons, the "Today's children, tomorrow's world" campaign will focus on the young.Parents have a key role in influencing healthy habits in their children. We need to help parents to understand the long-terms benefits of a healthy lifestyle and to engage them as partners in cancer prevention activities that start early in life.From a prevention perspective, there is strong justification for focusing the campaign on what can be done to tackle four main cancer-causing factors: (1) avoid tobacco and second-hand smoke, (2) avoid obesity, be physically active, and adopt healthy diets, (3) learn the facts about viruses, infections and new vaccinations, and (4) be smart in the sun. [1]The campaign message globally consists of four key precepts:1. provide a smokefree environment for children ("no smoking in homes")2. encourage an energy-balanced lifestyle (regular physical activity and low-fat diet, avoid obesity)3. learn the facts about vaccinations (HBV & HPV)4. teach your children to be sun-smartIn the course of this campaign, UICC, its member organizations and its partners throughout the world will engage in awareness-building, information-sharing, educational activities and community mobilization.Around 700 million children - almost half of the world's children - breathe air polluted by tobacco smoke, particularly at home

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smoking
smoking India caught in catastrophic smoking epidimic Researchers predict 1M tobacco deaths a year during the 2010sIndia is in the midst of a catastrophic epidemic of smokingdeaths that is expected to cause about one million (10 lakh) deaths a year during the 2010s - including one in five of all male deaths and one in 20 of all female deaths at ages 30-69. On average, male bidi smokers lose about six years of life, female bidi smokers lose about eight years and male cigarette smokers lose about ten years.The findings are from the first nationally representative study of smoking in India as a whole. The research, led by a team from India, Canada and the UK, is published online today (February 13, 2008)[1] in the New England Journal of Medicine.About 900 field workers surveyed all adult deaths during 2001-2003 in a nationally representative sample of 1.1 million (11 lakh) homes in all parts of India. Researchers compared smoking histories of 74,000 adults who had died with 78,000 living controls.Among men in the study who died at ages 30-69, smoking caused about:38% of all deaths from tuberculosis (1,174 out of 3,119 deaths)31% of all deaths from respiratory disease (1,078 out of 3,487)20% of all deaths from vascular disease (1,102 out of 5,409)32% of all deaths from cancer (709 out of 2,248)23% of all deaths from disease (5,651 out of 25,290)Lead author Professor Prabhat Jha of the Centre for Global Health Research (CGHR), St. Michael's Hospital, University of Toronto, Canada, said: "The extreme risks from smoking that we found surprised us, as smokers in India start at a later age than those in Europe or America and smoke less. And, smoking kills not only from diseases like cancer and lung diseases but also from tuberculosis and heart attacks.In India, there are about 120 million (12 crore) smokers. More than one-third of men and about five per cent of women aged 30-69 smoke either cigarettes or bidis (which contain only about a quarter as much tobacco as a cigarette, wrapped in the leaf of another plant - temburni).The study found that, among men, about 61% of those who smoke can expect to die at ages 30-69 compared with only 41% of otherwise similar non-smokers. Among women, 62% of those who smoke can expect to die at ages 30-69 compared with only 38% of non-smokers.I am alarmed by the results of this study," said India's Health Minister Dr Abumani Ramadoss. "The government of India is trying to take all steps to control tobacco use - in particular by informing the many poor and illiterate of smoke risks"."It is truly remarkable that one single factor, namely smoking, which is entirely preventable, accounts for nearly one in ten of all deaths in India. The study brings out forcefully the need for immediate public action in this much neglected field", states Professor Amartya Sen, Nobel Laureate in Economics, 2001.The study found there were no safe levels of smoking, but while the hazards of smoking even a few bidis a day were substantial, the dangers of cigarette smoking were even greater, corresponding to more than a doubling of the risk of death in middle age. This suggests that cigarette smokers lose about 10 years of life compared to non-smokers - risks similar to those seen in the West."Smoking kills, but stopping works - about a quarter of all smokers will be killed by tobacco in middle age, unless they stop," said co-author Professor Sir Richard Peto of Oxford University. "British studies show that stopping smoking is remarkably effective."Summary of key findingsThis is the first nationally representative study of smoking in India as a whole;During the 2010s there will be about one million (10 lakh) tobacco deaths a year in India;About 70% of these one million deaths will be before old age; meaning 700,000 (7 lakh) per year killed at ages 30-69 (600,000 men and 100,000 women);Tobacco is responsible for 1 in 5 of all male deaths and 1 in 20 of all female deaths in middle age (i.e., at ages 30-69);Men who smoke bidis lose on average six years of expected life, women who smoke bidis lose about eight years and men who smoke cigarette smokers lose ten years;Smoking kills mainly by tuberculosis, respiratory and heart disease, but also by cancer;Even smoking only a few (1-7) bidis a day raised mortality risks by one-third, and smoking only a few (1-7) cigarettes a day nearly doubled the risk;Most of the gap between male and female mortality rates in middle age is due to smoking;Substantial hazards were found both among educated and among illiterate adults and were found both in urban and in rural areas;Stopping smoking works - but, only 2% of adults have quit in India, and often only after falling ill.NoteIndian and western numbers: 1 lakh=100 thousand, 10 lakh=1 million, 1 crore=10 million

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E.N.T-CSOM  


CHRONIC SUPPURATIVE OTITIS MEDIA

It is a long standing infection of a part or

whole of the middle ear cleft charactrised

by ear discharge and a perforation.

Epidemiology

Incidence of CSOM is higher in developing

countries because of low socio-economic

standards,poor nutrition and lack of

health education.

It affects both sexes and all age groups.


Types of CSOM

It is divided into two types

1)Tybotympanic

2)Atticoantral



1)Tybotympanic

It is also called safe or benign type and

it involves anterioinferior part of middle

ear cleft and is associated with a central

perforation.

Aetiology

It is common in childhood

It is the sequela of acute otitis media

usuallyfollowing exanthematous fever

Ascending infection via the eustachian tube.

Pathology

1)Perforation of pars tensa

2)Edematous of middle ear mucosa

3)Polyp in external canal

4)Some degree of nicrosis in ossicular chain

5)Tympanosclerosis

6)Fibrosis and adhesions

Bacteriology

Common aerobic organims-

1)PS aeruginosa

2)Proteus

3)Esch. coli

4)staph. aureus

common anaerobes are

1)Bacteroides fragilis

2)anaerobic sreptococci

Clinical Features

1)Ear discharge

2)Hearing loss

3)Perforation of tympanic membrane

4)Oedematous and swollen of middle ear

Investigation

1)Examination under microscope

2)Audiogram

3)Culture and sensitivityof ear discharge

4)Mastiod x-rays

Treatment

1)aural tiolet

2)ear drops containing neomycin,

polymyxin,chloromycetin.

3)systemic antibiotics

4)precausions

5)treatment of contributory causes

6)surgical treatment

7)reconstrutive surgery

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E.N.T-A.S.O.M  


ACUTE SUPPURATIVE OTITIS MEDIA

It is an acute inflammation of middle ear cleft by

pyogenic organisms .

(Middle ear cleft i.e. eustachian tube,middle

ear,attic,antrum and mastiod air cells)



Aetiology

More commen in infants and children of lower

socio-economic groups.

Ratio of male:femail is 1:1



Routes of infection

1)Via eustachian tube

2)Via external ear

3)Blood borne



Predisposing factors

1)Recrrent attacks of common cold

2)upper respiretory tract infections

3)Exanthomatous fevers

4)Infections of tonsils and adenoids

5)Chronic rhinitis and sinusitis

6)Nasal allergy

7)Cleft palate

8)Tumors of nasopharynx



Causative organisms

1)Strptococcus pneumoniae(30%)

2)Haemophilus influenzae(20%)

3)Moraxella catarrhalis(12%)
others

4)Streptococcus pyogenes

5)Staphylococcus aureus

6)Pseudomonos aeruginosa



Pathology

The disease runs through the following stages

1)Stage of tubal occlusion

2)Stage of pre-suppuration

3)Stage of suppuration

4)Stage of resolution or complication



Treatment

1)Antibacterial therapy

2)Decongestant nasal drops

3)Oral nasal decongestants

4)Analgesics and antipyretics

5)Ear tiolet

6)Dry local heat

7)Myringotomy

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anaemia  


INTRODUCTION

Anaemia is defined as a reduction of the red blood cell (RBC) volume or hemoglobin concentration below the range of values occurring in healthy persons.



Age

Range (gm/dl)

2wks

13.0 – 20.0

3 months

9.5 – 14.5

6 months – 6yrs

10.5 – 14.0

7 - 12 yrs

11.0 – 16.0



Iron deficiency anaemia in children and infants is very common. It is the most frequent cause of anaemia and perhaps the most common single nutrient deficiency in developing countries like India.

history

Iron was used in the treatment of anaemia since ancient times “Loha Bhasma” was used by the Ayurvedic physicians in treatment of anaemia in India long time ago, Hippocrates, the father of medicine, used iron for treating weak and pale people. The Greek physicians used iron for treating weakness which is one of the important symptoms of anaemia. Sydenham was the first person to put on paper the use of iron. He wrote “we gave mars in the pale colour”.

chemistry and source

IRON : Iron is a chemical element with symbol Fe and atomic number 26. Iron is a group 8 and period 4 element.9 Iron is lustrous and silvery in color. It is one of the few ferromagnetic elements. Its melting point is 1538o C and boiling point is 2862oC. Most of the iron in the earth’s crust is found combined with oxygen as iron oxide minerals such as hematite and magnetite.9 Iron oxidises readily in air and water to form Fe2O3 and is rarely found as a free element. Good sources of dietary iron include red meat, fish, poultry, lentis, beans, leaf vegetables, tofu, chickpeas, black – eyed peas, fortified bread, and fortified breakfast cereals.9 Iron in meat is more easily absorbed than iron in vegetables (haem iron). Iron provided by dietary supplements is often found as iron (II) fumarate, although iron sulphate is cheaper and is absorbed equally well. Iron is most available to the body when chelated to aminoacids – iron in this form is ten to fifteen times more bioavailable11 than any other, and is also available for use as a common iron supplement. Often the aminoacid chosen for this purpose is the cheapest and most common aminoacid, glycine, leading to “iron glycinate” supplements

absorption and metabolism



IRON :

Iron is mainly absorbed in the duodenum. About 10% of dietery iron usually absorbed.15 However, in iron deficient (anaemic) individuals and growing children, a much higher proportion of dietary iron is absorbed to meet the increased body demands.

Factors affecting Fe absorption15

1. Acidity, ascorbic acid and cysteine promote iron absorption

2. In iron deficiency anaemia, Fe absorption is increased to 2-10 times than that of normal.

3. Phytate (found in cereals) and oxalate (found in leafy vegetables) interfere with Fe absorption.

4. A diet with high phosphate content decreases Fe absorption while low phosphate promotes.

5. Impaired absorption of iron is observed in malabsorption syndromes.CLINICAL FEATURES

Severity of anaemia symptoms and management

2. Speed of its development

3. Primary disease causing anemia

4. Presence of other co-morbid conditions

The following symptomatology should alert the clinician to look for anaemia.

a) Often asymptomatic in mild anaemia

b) Weakness, fatigue, lethargy

c) Tiredness, dizziness

d) Light headedness, headache, ,lack of concentration

e) Breathlessness on exertion, palpitation, congestive cardiac failure IRON :

iron deficiency may results from

1. low iron stores

2. reduced iron intake

3. excessive losses of iron from the body

4. decreased iron absorption

5. incresed iron demands RECOMMENDATIONS



investigations

Hb% (gm/dl)



Peripheral smear : 1. microcytic hypochromic 2. normocytic normochromic

3. macrocytic



Reticount



Iron(microgm/dl)



Zinc(microgm/dl)



Copper(microgm/dl)



Lead(microgm/dl)





ALAD activity



%Stimulation ALAD



treatment

· Iron supplementation should be given in case of nutritional anaemia, as the effects of iron deficiency will depend on the duration and severity of the anaemia. If left untreated, it may lead to behavioural or learning problems. These may not be reversible, even with later iron supplementation.

· Iron deficiency anaemia is the commonest cause of nutritional anaemia, it can be prevented by following recommendations :

a) Infants younger than 1yr should drink breast milk or an infant formula supplemented with iron. It is important for breastfed infants to receive iron fortified solid foods starting at about 6 months of age.

b) Children under 2yrs should have no more than 24 ounces of cows milk a day. Cows milk can inhibit absorption of iron, and drinking too much milk can dampen a child’s appetite for other iron rich foods.

c) Foods with nutritious sources of iron should be given to children especially during periods of rapid growth : lean meat, fish, egg yolk, beans, spinach, green leafy vegetables and fortified bread. Iron fortified foods should be given to those who take only vegetarian diet as iron from plant sources is less easily absorbed than meat sources

6. defective iron metabolism

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