Biomedical subjects
Publications and source records attributed to R Samuel.
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A study was undertaken in Bangalore City, India, to find out whether people with chest symptoms, including tuberculosis patients, attend general health institutions or report directly to tuberculosis clinics. The attendance for one day at 19 general dispensaries was investigated. Of the total of 2506 eligible persons who were questioned about the presence of chest symptoms, 1170 admitted having symptoms suggestive of pulmonary tuberculosis and 20 cases and 31 suspected cases of pulmonary tuberculosis were diagnosed. The findings indicate that tuberculosis patients do not by-pass the city health institutions. On the other hand, if these institutions take an active part in the tuberculosis programme and undertake diagnostic functions, or refer persons with chest symptoms to a central clinic, they can contribute substantially to case-finding.
We report the successful implementation of a community-based lymphatic filariasis control program using annual single-dose treatment with diethylcarbamazine (DEC) in combination with albendazole. The target population included over 28,000 people in the Samarai Murua District, Milne Bay Province, Papua New Guinea. A community-based delivery model was as effective as the standard health services delivery model. The number of people tested in 1998 before mass drug administration (MDA) and in 1999, one year after treatment, were 1644 and 942 respectively; the number who received mass treatment was 29,883 in 1998 and 28,965 in 1999. The prevalence of antigenaemia decreased significantly from 19% to 12%. The cost of running the program also decreased by 50%. The total number of trained health staff required to conduct the MDA program declined from 62 in 1998 to 12 in 1999, a reduction of 81%, with a cost saving in salary and allowances. A salient organizational initiative that surfaced was the use of local expertise in the private sector as a catalyst for obtaining funds from external sources to manage and facilitate the program which was conducted with locally available resources.
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Frozen, unstained sections of synovial tissue of a 38-year-old man with recurrent monoarthritis and hyperuricemia were studied. Negatively birefringent crystals in a spherulite form were detected by using a compensated polarized light microscope. It is postulated that in some cases of gout the first stage of crystallization is in the spherulite form.
This paper describes a joint project carried out by clinical psychologists and senior trusts managers to identify and measure consumer outcomes across a range of community services. The outcomes identified have been written into service contracts, and the outcome data are collected on a regular basis and used to inform management decisions.