Groundwater Storage Trends and Their Link to Farmer Suicides in Maharashtra State, India

Threats posed by land degradation and desertification continue to destabilize India's agriculture productivity and food security. The enduring negative environmental consequences of the agricultural intensification that started during the 1960s have further contributed to the depletion of soil nutrients in farmlands through heavy input of chemical fertilizers and pesticides. More than half of India's population depends on farming. When crop productivity fails, the economically-depressed farmers are unfortunately pushed toward suicide. The news of farmers committing mass suicide in Maharashtra state of India has lately received world attention. Although suicide may involve various psychological, social and economic factors, access to irrigation water remains a contentious matter in the agriculture business. The groundwater (GW) data from government sources are limited and not displayed in the public domain for verification. Hence, this study used the Gravity Recovery and Climate Experiment (GRACE) satellite data to compare farmer suicide rate in Maharashtra with GW storage estimates at broad spatiotemporal scales. The results show significant correlations (r = -0.85, p < 0.005) between water storage and suicide rate when time lags of 2 years are introduced between them. Based on the new findings, this study recommends that the GW status needs to be monitored scientifically across India's suicide zone. By doing so, the worst case scenarios can be logically predicted well in advance. The government then may have the advantage to mobilize its resources on the ground to implement rapid emergency measures and farmer consultations to minimize future farmer suicide cases.

aDolescents gEnder surVey, rEsponsible coupLes evaluatiOn, and capacity building Project in India (DEVELOP): a study protocol

Gender-based violence against women is a serious concern in India. This affects the health and wellbeing of victims and their dependents. Published evidence has documented a variety of reasons for such violence in Indian societies, paving a pathway to design, implement, and evaluate intervention models to address this issue. DEVELOP is a research study designed by UK and Indian research teams to plan future projects to address gender-based discrimination and violence against women and girls in India. This study protocol provides detailed information on the objectives, research methods, data collection, storage, analysis, and dissemination plans of the DEVELOP. The first component is a survey of adolescent boys and girls from rural areas of Maharashtra state of India to understand their gender equality related knowledge and beliefs. The insight gathered will be used to design interventions targeted at adolescent populations through future research and development programmes. Secondly, an evaluation of the 'Responsible Couples' project will be conducted to assess its success and challenges, and to design suitable programme activities and models. The 'Responsible Couples' project is implemented in 40 villages of Maharashtra state to improve relationships in married couples, prevent violence against women, intervene during violence, and to provide support services for women and their family members. Research findings will be disseminated though public engagement events in India, international conferences, and peer reviewed publications. This will impact on the policy and work models of Indian partners to plan future project investments. Research findings will be also useful for local government authorities and non-government agencies striving to advance gender equality.

aDolescents gEnder surVey, rEsponsible coupLes evaluatiOn, and capacity building Project in India (DEVELOP): a study protocol

Domestic violence and assault (DVA) against women is a serious concern in India. This affects the health and wellbeing of victims and their dependents. Published evidence has documented a variety of reasons for such violence in Indian societies, paving a pathway to design, implement, and evaluate intervention models to address this issue. DEVELOP is a research study designed by UK and Indian research teams to plan future projects to address gender-based discrimination and DVA against women and girls in India. This study protocol provides detailed information on the objectives, research methods, data collection, storage, analysis, and dissemination plans of the DEVELOP phase 1 work (2018-19). The first component is a survey of adolescent boys and girls from rural areas of the Maharashtra state of India to understand their gender equality related knowledge and beliefs. The insight gathered will be used to design interventions targeted at adolescent populations through future research and development programmes. Secondly, an evaluation of the 'Responsible Couples' project will be conducted to assess its success and challenges, and to inform future programme activities and strategy. The 'Responsible Couples' project is implemented in 40 villages of Maharashtra state to improve relationships in married couples, prevent violence against women, intervene during violence, and to provide support services for women and their family members. Research findings will be disseminated though public engagement events in India, international conferences, and peer reviewed publications. Secondly, our two key partners (SWISSAID and HMF) will benefit from such evidence to inform their on-going as well as forthcoming projects on gender equality in India.  Research findings will be also useful for local government authorities and non-government agencies striving to advance gender equality.

The Department of Neurosurgery, Grant Medical College and Sir J.J Group of Hospitals, Mumbai

The Department of Neurosurgery was founded in the Grant Medical College, Mumbai, in the year 1958, and is celebrating its 60^th anniversary. The history of Neurosurgery in this Institute is synonymous with the history of Neurosurgery in the state as this was one of the first government medical colleges to start a Neurosurgery Department within the state. The students after undergoing their rigorous training in the department, went on to establish advanced neurosurgical centers throughout Maharasthra and in several other parts of the country. The patients opt for this institution to get a standard of care that may be comparable with the highest standards prevalent, and the students achieve their goal of getting excellent education in Neurosurgery at par with the best institutes of the world. The department has, therefore, over the years, established its place in the country as a premier training facility and an epitome of medical excellence. This article traces the illustrious history of the Department of Neurosurgery, Grant Medical College and Sir J.J. Group of Hospitals, Mumbai, and also of the eminent faculty members and residents, who helped in advancing the standards of Neurosurgery in the region as well as the rest of India.

Baseline radionuclide concentration in selected marine organisms around the coastal areas of Ratnagiri and Sindhudurg districts, west coast of Maharashtra, India

The present work deals with assessment of baseline radionuclide concentration in marine organisms around selected coasts of Maharashtra, India. This baseline study highlights concentrations of natural and fallout radionuclides in finfish and shellfish species found in the surrounding seawater. Water and fish samples were collected, processed, and analyzed for ²³⁸U, ²²⁶Ra, ²²⁸Ra, ²³²Th, ⁴⁰K, and ¹³⁷Cs by high-resolution gamma spectrometry. ²³⁸U, ²²⁶Ra, ²²⁸Ra, ²³²Th, ⁴⁰K, and ¹³⁷Cs concentrations were found to be in the range of ≤1.5, ≤2.0, ≤0.4, ≤1.5, ≤8.0 to 258, and ≤0.2 Bq/kg, respectively. The seasonal study revealed the maximum concentration in premonsoon season. Activity concentrations were higher in pelagic fish than those in demersal fish. A higher concentration factor was reported in shellfish than in finfish.

Household food insecurity and children's dietary diversity and nutrition in India. Evidence from the comprehensive nutrition survey in Maharashtra

We analyse data from the 2012 Comprehensive Nutrition Survey in the State of Maharashtra, India, which surveyed 2,630 households. This is a unique dataset because in addition to nutritional status of mothers and children, it has information on diets of women and children and household food security. This rich dataset allows us to address three issues: whether household food security predicts higher diet diversity in children aged 6-23 months; whether household food security predicts lower risk of undernutrition; and whether the lower risk of undernutrition in children who live in food secure households is mediated by improved diet diversity for children. We find that children from moderately food insecure and severely food insecure households are more likely to have lower diet diversity scores. We find that the odds of a child being severely stunted, severely underweight, or severely wasted are higher in severely food insecure households. After controlling for children's diet diversity, and other child, maternal and household characteristics, we find that household food security is no longer statistically associated with stunting, wasting, or underweight. However, diet diversity of children is statistically significantly associated with whether a child is stunted or underweight. Our results although not causal provide evidence for understanding the extent to which household food insecurity affects children's diet diversity and how both these factors affect nutrition outcomes in children. Our analysis informs Government of Maharashtra's and India's National Nutrition Mission in their efforts for formulating appropriate policies and programmes to address child undernutrition.

Block-wise comprehensive health index in Gadchiroli: A tribal district in Maharashtra

BACKGROUND

The National Health Mission expects bottom-up approach for preparing Project Implementation Plan and also expects special attention toward tribal areas. Some district-level health information is available from national health surveys, but subdistrict-level information is mostly not available. Gadchiroli is the farthest district from the state capital. There are 12 blocks in the district. It is a notified tribal district having 8.61%-81.50% tribal population in different blocks and block-wise urbanization varies from 0.00% to 37.10%.

OBJECTIVES

The objective was to assess community health status at block level in Gadchiroli district and then develop comprehensive health index for ranking the blocks.

METHODS

The author has used available secondary data sources including Census, Survey of Cause of Death scheme, health management information system, Directorate of Economics and Statistics, and Maharashtra Medical Council. Ten indicators were selected after discussion with public health specialists to evolve comprehensive health index. Blocks having best statistic in each indicator were given 100 marks and other blocks were given proportionate marks. Thus, the highest possible score for any block was 1000.

RESULTS

The range of block-wise score was from 424 to 781. The highest scoring block was Gadchiroli and was an outlier. The comprehensive score was having correlation with urbanization, r = 0.63 (95% confidence limits, 0.09-0.88). After principal component analysis, the extracted three components were responsible for most of the variations.

CONCLUSIONS

Reasonably reliable and valid block-wise data are available to carry out community health assessment and develop comprehensive health index. The index is useful for comparison among blocks.

Kyasanur Forest Disease Prevalence in Western Ghats Proven and Confirmed by Recent Outbreak in Maharashtra, India, 2016

INTRODUCTION

Kyasanur forest disease (KFD) outbreak was confirmed in Dodamarg Taluka, Sindhudurga district (Maharashtra) in India during the year 2016. The rise in suspected KFD cases was reported in January 2016, peaked during March, and then declined gradually from April 2016. The outbreak was thoroughly investigated considering different socio-clinical parameters.

METHODS

Total, 488 suspected KFD cases were investigated using KFD specific real-time RT-PCR and anti-KFDV IgM enzyme-linked immunosorbent assay (ELISA). Sero-epidemiological survey was carried out in the affected area using anti-KFDV IgG ELISA.

RESULTS

Among suspected KFD cases, high age-specific attack rate (105.1 per 1000 persons) was observed in adults (aged 40-59 years). Out of 488 suspected KFD cases, 130 were laboratory confirmed. Of these, 54 cases were KFDV real-time RT-PCR positive, 66 cases were anti-KFDV IgM ELISA positive and 10 cases were positive by both the assays. Case fatality ratio among laboratory-confirmed KFD cases were 2.3% (3/130). Majority of laboratory-confirmed KFD cases (93.1%) had visited Western Ghats forest in Dodamarg for activities like working in cashew nut farms (79.8%), cashew nut fruit collection (76.6%), collection of firewood (68.5%) and dry leaves/grass (40.3%), etc., before the start of symptoms. Common clinical features included fever (100%), headache (93.1%), weakness (84.6%), and myalgia (83.1%). Hemorrhagic manifestations were observed in nearly one-third of the laboratory-confirmed KFD cases (28.5%). A seroprevalence of (9.7%, 72/745) was recorded in KFD-affected area and two neighboring villages (9.1%, 15/165). Serosurvey conducted in Ker village showed clinical to subclinical ratio of 6:1 in KFD-affected areas.

CONCLUSION

This study confirms the outbreak of KFD Sindhudurg district with 130 cases. Detection of anti-KFDV IgG antibodies among the healthy population in KFD-affected area during the KFD outbreak suggested the past exposure of KFD infection. This outbreak investigation has helped health authorities in adopting KFD vaccination strategy for the population at risk.

A new allele of the kappa-casein gene in local zebu cattle breeds

Local zebu cattle breeds in Indian villages are crossbred with exotic breeds at an unprecedented rate without utilising the full potential of genomic technologies. In addition to agriculture produce, livestock, particularly cattle, constitute a vital source of livelihood for farmers in India. Age-old agricultural practices, errant monsoon, and frequent crop failures have resulted in Maharashtra having the highest number of farmer suicides in the country. Local cattle breeds are considered low-yield breeds and thus are primarily used as beasts of burden. Information on functional gene variants in Indian cattle breeds is scant and limited to PCR-RFLP study in few breeds. In this study, 32 samples from 8 cattle breeds were obtained from remote villages of Maharashtra state. By using the re-sequencing technology, we sequenced 403 bp of the exon IV CSN3 allele and inferred its haplotypes. From 32 samples, 14 genotypes (G1–G14) defined by 7 single-nucleotide polymorphisms (SNP's) were identified. From these 14 genotypes, we reconstructed 3 haplotypes (H01, H02, and H03) and estimated their frequencies. Of the 3 haplotypes, two (H01 and H03) corresponded to CSN3*B4 and CSN3*B and CSN3*H and CSN3*G alleles, respectively. The third haplotype H02 was identified as a new allele and differed from CSN3*B4 and CSN3*B and CSN3*H and CSN3*G alleles by one nonsynonymous mutation at the position C5306T-Ile100Thr. The neighbour-joining tree reconstruction revealed haplotype sharing or hybridisation between B. t. indicus and B. t. taurus because the 3 haplotypes originated in this study clustered with A1, B2, B4, B, G, and H alleles, which were reported previously in both the subspecies of B. taurus. The occurrence of one new allele in a small sample size highlights the urgency to screen local zebu cattle breeds by using genomic tools for circumventing genetic erosion that is widespread in Indian villages in India.

Determinants of stunting and poor linear growth in children under 2 years of age in India: an in-depth analysis of Maharashtra's comprehensive nutrition survey

Abstract

We use a representative sample of 2561 children 0–23 months old to identify the factors most significantly associated with child stunting in the state of Maharashtra, India. We find that 22.7% of children were stunted, with one‐third (7.4%) of the stunted children severely stunted. Multivariate regression analyses indicate that children born with low birthweight had a 2.5‐fold higher odds of being stunted [odds ratio (OR) 2.49; 95% confidence interval (CI) 1.96–3.27]; children 6–23 months old who were not fed a minimum number of times/day had a 63% higher odds of being stunted (OR 1.63; 95% CI 1.24–2.14); and lower consumption of eggs was associated with a two‐fold increased odds of stunting in children 6–23 months old (OR 2.07; 95% CI 1.19–3.61); children whose mother's height was < 145 cm, had two‐fold higher odds of being stunted (OR 2.04; 95% CI 1.46–2.81); lastly, children of households without access to improved sanitation had 88% higher odds of being severely stunted (OR 1.88; 95% CI 1.17–3.02). Attained linear growth (height‐for‐age z‐score) was significantly lower in children from households without access to improved sanitation, children of mothers without access to electronic media, without decision making power regarding food or whose height was < 145 cm, children born with a low birthweight and children 6–23 months old who were not fed dairy products, fruits and vegetables. In Maharashtra children's birthweight and feeding practices, women's nutrition and status and household sanitation and poverty are the most significant predictors of stunting and poor linear growth in children under 2 years.

Factors associated with preterm delivery and low birth weight: a study from rural Maharashtra, India

Background: Although preterm delivery and low birth weight (LBW) have been studied in India, findings may not be generalisable to rural areas such as the Marathwada region of Maharashtra state. There is limited information available on maternal and child health indicators from this region. We aimed to present some local estimates of preterm delivery and LBW in the Osmanabad district of Marathwada and assess available maternal risk factors.

Methods: The study used routinely collected data on all in-hospital births in the maternity department of Halo Medical Foundation’s hospital from 1 ^st January 2008 to 31 ^st December 2014. Multivariable logistic regression analysis provided odds ratios (OR) with 95% confidence intervals (CI) for preterm delivery and LBW according to each maternal risk factor.

Results: We analysed 655 live births, of which 6.1% were preterm deliveries. Of the full term births (N=615), 13.8% were LBW (<2.5 kilograms at birth). The odds of preterm delivery were three times higher (OR=3.23, 95% CI 1.36 to 7.65) and the odds of LBW were double (OR=2.03, 95% CI 1.14 to 3.60) among women <22 years of age compared with older women. The odds of both preterm delivery and LBW were reduced in multigravida compared with primigravida women regardless of age. Anaemia (Hb<11g/dl), which was prevalent in 91% of women tested, was not significantly related to these birth outcomes.

Conclusions: The odds of preterm delivery and LBW were much higher in mothers under 22 years of age in this rural Indian population. Future studies should explore other related risk factors and the reasons for poor birth outcomes in younger mothers in this population, to inform the design of appropriate public health policies that address this issue.

Prevalence of iron-deficiency anaemia and risk factors in 1010 adolescent girls from rural Maharashtra, India: a cross-sectional survey

OBJECTIVE

Iron-deficiency anaemia (IDA) is the most common nutritional disorder observed in adolescent girls in India. Our aim was to investigate the prevalence and risk factors associated with IDA in rural Maharashtra, India, to address current evidence gaps.

STUDY DESIGN

Cross-sectional survey.

METHODS

The study recruited 13- to 17-year-old adolescent girls living in 34 villages of Osmanabad district. Data were collected on individual health, dietary, sociodemographic factors, and anthropometric measurements were taken. Haemoglobin (Hb) levels were measured using Sahli's haemometer. Logistic and linear regressions were used to identify risk factors associated with IDA and Hb levels, respectively.

RESULTS

Among 1010 adolescent girls (response rate 97.5%), the mean Hb was 10.1 g/dl (standard deviation = 1.3), and 87% had anaemia (Hb < 12 g/dl). The prevalence of mild (11.0-11.9 g/dl), moderate (8.0-10.9 g/dl) and severe (Hb ≤ 7.9 g/dl) anaemia was 17%, 65% and 5%, respectively. Anaemia likelihood increased significantly with age (odds ratio (OR): 1.41 per year, 95% confidence interval (CI): 1.17-1.70). Factors associated with decreased anaemia risk were mid-upper arm circumference (MUAC) ≥22 cm (OR: 0.51, 95% CI: 0.31-0.82), ≥3 days/week consumption of fruit (OR: 0.35, 95% CI: 0.23-0.54) or rice (OR: 0.39, 95% CI: 0.17-0.91), and incomplete schooling (OR: 0.47, 95% CI: 0.24-0.91). In the final model lower age, MUAC and fruit consumption were significantly associated with Hb level.

CONCLUSION

Anaemia prevalence was extremely high among adolescent girls in rural areas of Maharashtra. Whilst we identified risk factors that could be used for targeting interventions, there is urgent need of comprehensive preventative interventions for the whole adolescent girl population.

Pethia sanjaymoluri, a new species of barb (Teleostei: Cyprinidae) from the northern Western Ghats, India

Pethia sanjaymoluri, a new cyprinid, is described from the Pavana and Nira tributaries of Bhima River, Krishna drainage, Maharashtra, India. It can be distinguished from congeners by a combination of characteristics that includes an incomplete lateral line, absence of barbels, upper lip thick and fleshy, 23-25 lateral series scales, 7-12 lateral-line pored scales, 10 predorsal scales, 11-14 prepelvic scales, 17-20 pre-anal scales, 4½ scales between dorsal-fin origin and lateral line, four scales between lateral line and pelvic-fin origin, 8-15 pairs of serrae on distal half of dorsal-fin spine, 12-14 branched pectoral-fin rays, 4 + 26 total vertebrae, 4 + 5 predorsal vertebrae, 4 + 13 abdominal vertebrae, 13 caudal vertebrae and a unique colour pattern comprising a humeral spot positioned below the lateral line and encompassing the third and fourth lateral-line scales and one scale below, one caudal spot on 17th-21st lateral-line scales with a yellow hue on its anterior side and apical half of dorsal fin studded with melanophores making the fin tip appear black. Genetic analysis based on the mitochondrial cytochrome b gene sequence suggests that the species is distinct from other known species of Pethia for which data are available.

Association between tribal status and spacing contraceptive use in rural Maharashtra, India

This study examines associations between tribal status and spacing contraception use (SCU) in rural Maharashtra, India. Cross-sectional analyses were conducted on baseline survey data from non-sterilized married couples (n = 867) participating in the CHARM family planning evaluation study. Participants were aged 18-30 years and 67.6% were tribal; 27.7% reported current SCU. Crude regression analyses indicated that tribals were less likely to use contraception (AOR = 0.04, 95% CI = 0.29, 0.54); this association was lost after adjusting for education, higher parity and desire for pregnancy, factors associated with tribal status. Findings suggest that lower SCU among tribals is driven by social vulnerabilities and higher fertility preferences.

Study of Awareness, Enrollment, and Utilization of Rashtriya Swasthya Bima Yojana (National Health Insurance Scheme) in Maharashtra, India

INTRODUCTION

Government of India launched a social health protection program called Rashtriya Swasthya Bima Yojana (RSBY) in the year 2008 to provide financial protection from catastrophic health expenses to below poverty line households (HHs). The objectives of the current paper are to assess the current status of RSBY in Maharashtra at each step of awareness, enrollment, and utilization. In addition, urban and rural areas were compared, and social, political, economic, and cultural (SPEC) factors responsible for the better or poor proportions, especially for the awareness of the scheme, were identified.

METHODS

The study followed mixed methods approach. For quantitative data, a systematic multistage sampling design was adopted in both rural and urban areas covering 6000 HHs across 22 districts. For qualitative data, five districts were selected to conduct Stakeholder Analysis, Focused Group Discussions, and In-Depth Interviews with key informants to supplement the findings. The data were analyzed using innovative SPEC-by-steps tool developed by Health Inc.

RESULTS

It is seen that that the RSBY had a very limited success in Maharashtra. Out of 6000 HHs, only 29.7% were aware about the scheme and 21.6% were enrolled during the period of 2010-2012. Only 11.3% HHs reported that they were currently enrolled for RSBY. Although 1886 (33.1%) HHs reported at least one case of hospitalization in the last 1 year, only 16 (0.3%) HHs could actually utilize the benefits during hospitalization. It is seen that at each step, there is an increase in the exclusion of eligible HHs from the scheme. The participants felt that such schemes did not reach their intended beneficiaries due to various SPEC factors.

DISCUSSION AND CONCLUSION

The results of this study were quite similar to other studies done in the recent past. RSBY might still be continued in Maharashtra with modified focus along with good and improved strategy. Various other similar schemes in India can definitely learn few important lessons such as the need to improve awareness, issuing prompt enrollment cards with proper details, achieving universal enrollment, ongoing and prompt renewal, and ensuring proper utilization by proactively educating the vulnerable sections.

A synoptic account of flora of solapur district, maharashtra (India)

The present paper provides the first systematic and comprehensive account of the flora of Solapur district of Maharashtra (India). The flora of this region demonstrates a wide range of species diversity and growth forms. The vegetation of the district mainly represents tropical dry deciduous forests, thorny open scrub and vast grasslands. During the present work, a total of 1441 taxa belonging to 699 genera and 125 families of flowering plants were recorded. A new species Crinumsolapurense Gaikwad et al. is described. Fabaceae is the dominant family with 210 taxa, followed by Poaceae (157 taxa), Asteraceae (85 taxa), Malvaceae (68 taxa) and Euphorbiaceae (48 taxa). Acacia is the largest genus with 25 taxa, followed by Euphorbia (23), Cyperus (22), Crotalaria (19) and Ipomoea (19). The herbaceous flora of the district is notable as it amounts to 56.21% of the whole of flora. The ratio of indigenous woody to herbaceous components is 1:1.28. The proportion of indigenous taxa (978) to the cultivated ones (460) is 1.35: 0.5 in the district.

A new species of scorpion of the genus Neoscorpiops Vachon, 1980 (Scorpiones: Euscorpiidae) from India

A new species of scorpion of the genus Neoscorpiops Vachon, 1980 is described from Northern Maharashtra. Neoscorpiops maharashtraensis sp. nov. is a medium-sized scorpion species ranging from 36 to 42mm. Carapace, mesosoma and metasoma brown, legs and telson yellow; pedipalp in a shade of brown with carinae dark drown to black. Granulation on carapace coarse, with a few smooth patches; on mesosoma, which is restricted to the posterior half. Anterior margin of carapace with a moderately deep "U"-shaped emargination medially lacking elevated edges. Pectines well developed 7/7. Trichobothria on patella ventral 13-16. Pedipalp chela narrow and elongate in males, length-to-width ratio in males is 4.86-5.05.

Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Maharashtra cohort of the A1chieve study

BACKGROUND

The A1chieve, a multicentric (28 countries), 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726) in routine clinical care across four continents.

MATERIALS AND METHODS

Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Maharashtra, India.

RESULTS

A total of 3069 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Patients had started on or were switched to biphasic insulin aspart (n = 2115), insulin detemir (n = 461), insulin aspart (n = 333), basal insulin plus insulin aspart (n = 92) and other insulin combinations (n = 61). At baseline glycaemic control was poor for both insulin naïve (mean HbA1c: 8.8) and insulin user (mean HbA1c: 9.1%) groups. After 24 weeks of treatment, both the groups showed improvement in HbA1c (insulin naïve: -1.4%, insulin users: -1.4%). SADRs including major hypoglycaemic events or episodes did not occur in any of the study patients.

CONCLUSION

Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.

Severe Neurotoxic Envenoming and Cardiac Complications after the Bite of a 'Sind Krait' (Bungarus cf. sindanus) in Maharashtra, India

We report a case of severe envenoming with unusual complications and two anecdotal cases of fatalities following proven 17-scale-row ‘Sind krait’ (Bungarus cf. sindanus) bites on people sleeping in temporary huts at construction sites in Pune District, Maharashtra, India. A 25-yr-old male developed progressive neuromuscular paralysis, abdominal pain and autonomic disturbances complicated by four prolonged episodes of pulseless ventricular tachycardia requiring defibrillation, and followed by pulmonary edema secondary to impaired left ventricular systolic function and hyperfusion. There was no response to antivenom; mechanical ventilation was required for six days. Only one other case of fatal envenoming likely caused by this species had been reported previously in India. The distribution of B. sindanus sensu lato from eastern Afghanistan to India overlaps with that of the superficially very similar common krait (Bungarus caeruleus). Thus, B. cf. sindanus envenoming may be common but routinely overlooked or misdiagnosed.

Tobacco consumption and its association with education among women residing in a rural area of Maharashtra: A cross-sectional study

BACKGROUND

Tobacco use is increasing among women and girls across the globe as well as in all parts of India. In India, 8 to 10 lakh people die due to tobacco related diseases every year. This tobacco epidemic among women needs to be prevented.

OBJECTIVES

Study was conducted to find the prevalence and pattern of tobacco consumption and it's association with education among females (15-49 years) in a rural village of Pune, Maharashtra, India.

MATERIAL AND METHODS

A cross-sectional study was carried out among 313 females (15-49 years) in a rural field practice area of a Medical College in Pune during Feb 11 to May 11. Pre-tested questionnaire was used for collecting data by interview after obtaining informed consent. Statistical analysis was performed (Epinfo software version 3.5.3.).

RESULTS

Out of 313 female studied, 14.05% (44) and 0.96% (03) were found to be current and former tobacco user respectively while 84.98% (266) never used any form of tobacco in their lifetime. Mishri consumption (45%) was commonest form of smokeless tobacco use followed by quid use (36%). Majority of the tobacco users (54.55%) were illiterate. There was significant association between tobacco consumption and education level (p = 0.0295). Tobacco consumption was more with increasing age.

CONCLUSION

Tobacco consumption was found to be prevalent in 14.05% of women. Almost all of them used smokeless tobacco, mainly mishri. Tobacco consumption was directly associated with age and inversely with educational level. Therefore increasing women's literacy may bring down tobacco use among women.

Putting people first: a primary health care success in rural India

Background:

The World Health Report, 2008, contains a global review of primary health care on the 30th anniversary of the Declaration of Alma-Ata. The period covered by the study reported on here corresponds with that of the Report, allowing for a comparison of achievements and challenges in one primary health care centre vis-a-vis the WHO standards.

Materials and Methods:

This study uses qualitative and quantitative data from a rural primary care facility in Western Maharashtra, collected over three decades. It analyzes the four groups of reforms defined by WHO in the context of the achievements and challenges of the study facility.

Results:

According to the WHO Report, health systems in developing countries have not responded adequately to people’s needs. However, our in-depth observations revealed substantial progress in several areas, including in family planning, safe deliveries, immunization and health promotion. Satisfaction with services in the study area was high.

Conclusion:

Adequate primary health care is possible, even when all recommended WHO reforms are not fully in place.

Ethnomedicinal investigation in Nandurbar district of Maharasthtra

The aborigines exploit medicinal virtues of tubers, roots fruits, seeds, flowers, leaves etc. from the forest and use in a variety of ways. The are used in the form of juice, decoction, oil, paste, extract, infusion and powder. Fresh parts are also used and the substances like sugar, sugarcandy, groundnut oil, milk and cow-ghee are used as additives. The native uses of medicinal plants are employed to better stomachcomplaints, rheumatic pains, spermatorrhoea, tooth-ache, head-ache, ear-ache, weakness, urinal troubles, fresh cuts, tumors, fever, mouth ulcer, bone fracture and few other human diseases. Total 47 species are being reported for the aforesaid ailments of these, applications of 32 species are unknown or little known. These are, however, desired for further scientific assessments for obvious reasons.

Observations on plantlore in Buldhana District of Maharashtra

Traditional medicinal uses for various human diseases of 54 angiospermic species from Shegaon, Sangrampur, Jalgaon (Jamod), Malkapur, Nandura, Motala and Khamgaon tehsils of Buldhana district (Maharashtra) are reported. Of these, applications of 36 species are unknown or little known. The folk medicines consist of a sole drug or a principal drug in combination with other drugs. The recent botanical name, local plant name, recipe, mode of administration, doses etc. are communicated as collected from the tribal and rural folks of the district. It is desirable to screen these species on modern scientific lines.

Ethno - veterinary Plants of Nadurbar district of Maharashtra, India

A survey of medicinal plants of Nandurbar district of Maharashtra, India in regard to their veterinary uses, has been done. While collecting the data, special emphasis is given to the foot and Mouth disease, Haemorrhagic Septicaemia, Maggotted Wounds, Retention of Placcenta, Timpany and Worms, which are the most common animal ailment in the district. After short listing, about 29 plant species are found to be in regular use by various tribal veterinary doctors in the district.

Plants used in reproductive ailments by tribals of nasik district (maharashtra)

The study concerns the first-hand information gathered during ethnomedicinal surveys in Nasik district, Maharashtra, of plants traditionally used by aborigines and rural folks for the treatment of gynecological, genital and other related aspects. Uses of 25 angiospermic species belonging to 22 population. The paper gives botanical identity, family, local name, collection number and mode of administration.