Major issues involved in the evaluation of leprosy control programmes through MDT.
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Biomedical subjects
Publications and source records attributed to C K Rao.
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Observations made for a period of four years from 1985 to 1988 on post-spray impact of pirimiphos-methyl (25 per cent Wp) on malaria vectors in Tirap district of Arunachal Pradesh showed that a low density (0.0 to 0.02 PMH) of Anopheles dirus was maintained in the areas sprayed with the insecticide at the dosages of 1 and 2 g/m2 from 1981 to 1984. The post-spray data (1985 to 1988) showed a reduction of 62.5 to 62.8 per cent in SPR, 55.6 to 64.7 per cent in SRF and 72.3 to 75.5 per cent decline in API as compared to baseline data of 1980 in areas sprayed with pirimiphos methyl.
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The blood Cholinesterase (ChE) level of malathion in spraymen is continuously monitored through a "built-in warning system" existing under NMEP since the introduction of malathion spraying. The data available from the States of Maharashtra, Punjab and Gujarat revealed that, in spraymen of Punjab, the ChE level in 1988 and 1989 remained normal in about 99.8 per cent spray personnel, and in 1 out of 381 workers, the ChE level fell to 62.5 per cent during 1989. In Gujarat and Maharashtra, the normal level of ChE was maintained in nearly 88 and 98.4 per cent of spray personnel respectively during the spraying period. The ChE level fell to 62.5 per cent in 11.9 per cent of spray staff in Gujarat during 1987 and in 1.5 and 1.6 per cent persons during 1988 and 1989 respectively in Maharashtra. Only in three cases (0.07 per cent) out of 4,100 in Maharashtra showed depression in ChE to 50 per cent in 1988. In none of the above mentioned cases, there was any parasympathetic overstimulation or uneasiness, etc, even then they were withdrawn from spray and were given rest and where needed medical care.
The introduction of different types of pollutants like those from industrial effluence, bye-products from petro-chemical industries, pesticidal application, wastages of nuclear power industries, etc. is viewed seriously by the society. For the control of vectors of disease the adoption of environmental management is, therefore, imperative. The physical methods like drainage of excess and waste water, making water unsuitable for vector breeding by adopting various indigenous methods in vogue, the intra and inter-sectrol coordination and community based activities are identified as the basic approaches for achieving this goal. Minimising the potentiality of vector breeding through source reduction and water management is thought to be the simplest, cheapest and most permanent method. For the society having varying types of habitation and varying degree of habitational facilities like planned housing, water supply and disposal, sanitation and organized anti-vector measures, the adoption of environmental management to exercise check over vector population is a promising proposition. The suitability of such an approach has already been demonstrated by MRC, (ICMR), Delhi and V.C.R.C., Pondicherry. The implementation of these methods is to be initiated right from Primary Health Centre and district level onwards and community is to be motivated to the extent that the various methods of environmental management for vector control are adopted in the routine way of life. In the present article these ideas have been touched upon and various methods of environmental management described in brief. In addition what other Governmental agencies are required to do in order to effectively implement environmental management methods are briefly enlisted.
The integrated methodology for the control of vectors of diseases as well as mosquitoes has become an accepted concept amongst the public health experts. The feasibility of adopting this approach in different situations for mosquito control as per field trials by various institutions has been reviewed in this article. This concept, to some extent, has been in vogue under National Malaria Eradication Programme since long in a practicable way. Satisfactory results have been obtained wherever this approach has been applied carefully. The applicability of the integrated control methodology is not difficult provided various methods to be integrated are chosen and utilized in a rational way. Thorough health education is a prerequisite to awaken the community to accept the methods as part and parcel of routine life.
A study was undertaken to explore the feasibility of treatment of clinical cases of filariasis by the Village Health Guides (VHG) and to assess the impact of different dose schedules by Diethylcarbamazine (DEC) on the frequency of acute attacks. It was observed that six days treatment with DEC at a dose of 500 mg daily was the most effective regimen in controlling recurrence of filarial attacks. The VHGs can serve the community in treating filarial cases with DEC.
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The purification of human placenta and rat liver protein disulphide-isomerase (PDI, EC 5.3.4.1) and the production of a panel of monoclonal antibodies against these proteins are described. The physical and enzymic properties of human PDI and rat PDI were similar; immunological characterization revealed the presence of unique, as well as shared, antigenic determinants. Although purified rat liver PDI was present as three forms differing slightly in Mr value, evidence was presented that the multiple forms represent proteolytic degradation products of a single 59,000-Mr species. Purified human PDI had an apparent Mr of 61,200. Two of the monoclonal antibodies against human PDI partially inactivated the enzyme, and one of these in indirect immunoprecipitation led to the precipitation of all glutathione:insulin transhydrogenase activity from a crude extract of human placenta. Results of immunofluorescence experiments with HT-29 human colon carcinoma cells were consistent with localization of PDI in the nuclear membrane and cell cytoplasm.
A field trial of malaria vector control was conducted in Phulbani district, Orissa, during 1984 and 1985. Indoor-spraying of pirimiphos-methyl emulsion formulation was undertaken at an application rate of 2 g/m2 in two sections (population 14,692) of Nuagaon Primary Health Centre. Houses in two adjacent sections (population 21,450) were sprayed with DDT a water dispersible powder (wdp) formulation at 1 g/m2 for comparison purposes. Operational problems in this area come from the tendency of tribal people to re-plaster over wdp applications. Pre-spray malariological indices in the trial area were 38% slide positivity rate, 37% slide falciparum rate and 12.1% annual parasite incidence. Densities of Anopheles annularis Van der Wulp, An. culicifacies Giles, An. fluviatilis Theobald and other potential malaria vectors were reduced in the pirimiphos-methyl trial area 2-35-fold more than in the area sprayed with DDT. Malariological indices were reduced by 65-68% in the pirimiphos-methyl sprayed area compared with only 26-35% reduction in the DDT sprayed area. Spraymen and villagers experienced no adverse side-effects from residual house-spraying with pirimiphos-methyl emulsion and it is concluded that this organophosphate product has advantages for malaria vector control, especially in operationally difficult situations.
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