Health status of elderly population in rural area of Varanasi district

In order to assess the health problems of the elderly people and its relationship with advancement of age, a field based cross sectional study was carried out in two selected villages in the rural field practices area in Varanasi district. 88.8 % were found to suffer from one or more illness at the time of study. This resulted in the morbidity load of 1.93 illnesses per person. The morbidity was directly proportional to the age. The most common morbidity was arthritis with overall prevalence of 57.08% followed by cataract (48.33%), hypertension (11.25%). But the prevalence of old age related morbidities increased with advancing age (p<0.008). Compared to married people higher percentage of widow / widower (91.5%) suffered from old age related morbidities (p<0.01).

Modeling customer support performance in Indian IT hardware industry

Purpose

Customer support assumes strategic importance in India for branded IT‐hardware products. An authorized service center and a stream of specialized service centers undertake field services and represent a sale‐territory's support network. “Time constrained” service men have to deliver customized service meeting a promised time‐standard. The stochastic demand for support services severely mars the customer response resulting in poor service quality. A manufacturer has to address the following decisions under these conditions: what is the ideal staffing level in a territory considering restricted server availability? What will be the impact of changing the staffing levels on customer service level? This study develops an analytical model to address these decisions.

Design/methodology/approach

The study identifies the variables underlying stochastic service demand through a field survey and determines the demand distribution. Applying stochastic principles the study derives relation between field staffing level and customer response considering server time constraint. Study performs statistical analysis to validate this model with real time data on variables collected from the field survey.

Findings

The outcomes of analysis reveal the following findings: this model can be applied in service systems where a time constrained server has to deliver expected level of performance (research implication); and increasing field staffing levels obscures the significant difference between the customer waiting times under very high levels of uncertain demand (practical implication).

Originality/value

The study derives relation between the staffing levels and customer waiting time considering uncertain demand with restricted working hour conditions.

Offline testing of the ATHENA Hypertension decision support system knowledge base to improve the accuracy of recommendations

ATHENA-HTN is a clinical decision support system (CDSS) that delivers guideline-based patient-specific recommendations about hypertension management at the time of clinical decision-making. The ATHENA-HTN knowledge is stored in a knowledge-base (KB). Changes in best-practice recommendations require updates to the KB. We describe a method of offline testing to evaluate the accuracy of recommendations generated from the KB. A physician reviewed 100 test cases and made drug recommendations based on guidelines and the "Rules" (descriptions of encoded knowledge). These drug recommendations were compared to those generated by ATHENA-HTN. Nineteen drug-recommendation discrepancies were identified: ATHENA-HTN was more complete in generating recommendations (15); ambiguities in the Rules misled the physician (3); and content in the Rules was not encoded (1). Three new boundaries were identified. Three updates were made to the KB based on the results. The offline testing method was successful in identifying areas for KB improvement and led to improved accuracy of guideline-based recommendations.

Comment on "The great Sumatra-Andaman earthquake of 26 December 2004"

Lay et al. (Research Articles, 20 May 2005, p. 1127) estimated a 600-km length for the tsunami source region. Adding tide-gauge data from Paradip, the northernmost of the Indian east-coast stations and therefore the most critical constraint on the northern extent of the source, we estimate that its length was greater by approximately 30%.

Ultrasonographic assessment of thyroid volume in Delhi children

BACKGROUND

Ultrasonographic measurement of thyroid volume is increasingly being used to assess prevalence of iodine deficiency in a community.

OBJECTIVES

To assess thyroid volume by ultrasonography in normal Delhi children, and compare them with the recently adopted WHO reference standards.

METHODS

One hundred and three children aged of 6-10 years were enrolled from the paediatric outpatient clinic in a prospective study. Thyroid volume was estimated by ultrasound, and urinary iodine levels were measured for all subjects by spot urine samples.

RESULTS

Goitre prevalence was 24.3% on clinical assessment. Urinary iodine levels fell in the range of mild to moderate deficiency in 61% of the children. None of the children met the WHO recommended ultrasonographic criteria for goitre (thyroid volume >97th percentile of the reference standards), when WHO age-specific norms were used for comparison. On applying body surface area (BSA)-specific norms, only two children were classified as having goitre.

CONCLUSIONS

The WHO standards for thyroid volume by ultrasonography tended to underestimate goitre prevalence.

Quantum dots with disorder and interactions: a solvable large-g limit

We analyze the problem of interacting electrons on a ballistic quantum dot with chaotic boundary conditions, where the effective interactions at low energies are characterized by Landau parameters. When the dimensionless conductance g of the dot is large, the disordered interacting problem can be solved in a saddle-point approximation which becomes exact as g --> infinity (as in a large-N theory), leading to a phase transition in each Landau interaction channel. In the weak-coupling phase constant charging and exchange interactions dominate the low-energy physics, while the strong-coupling phase displays a spontaneous distortion of the Fermi surface, smeared out by disorder.

Bone marrow stem cell and progenitor response to injury

Hematopoietic stem cells represent a long term reservoir of cells to populate blood with multiple formed cells. These hematopoietic stem cells proliferate and mature into lymphoid, erythroid, and myeloid precursor cells, with the balance of these cell populations modulated by major thermal injury, with or without sepsis. Recent studies indicate that thermal injury shifts this balance to favor the monocyte/macrophage lineage at the expense of neutrophil production. The mechanisms for these changes are now being elucidated with the results of clinical importance, because understanding the dynamics of the different precursor pools could be used to identify patients at greater risk for systemic inflammatory sequelae following major thermal injury.

A critical review of the probable reasons for the poor variable bioavailability of rifampicin from anti-tubercular fixed-dose combination (FDC) products, and the likely solutions to the problem

The problem of poor/variable bioavailability of rifampicin, which is shown in particular when the drugs are present in anti-tubercular fixed-dose combination (FDC) products, is a matter of serious concern. There is a potential of failure of therapy in patients with an active disease. It perhaps also is a contributory factor towards the increasing resistance to anti-tubercular drugs. Unfortunately, the origin and cause of the problem is not clearly understood, though GMP and crystalline changes in the drug are invariably cited as the principal reasons. In this write-up, various probable physical and/or chemical reasons are critically reviewed. The enhanced decomposition of rifampicin in the presence of isoniazid in stomach after ingestion is indicated to be the key factor behind the problem. Some simple solutions offered by the knowledge of the cause are discussed and it is concluded that there is a need to have a multifaceted approach to handle the problem.

Helical CT angiography in evaluation of live kidney donors

BACKGROUND

Live kidney donor evaluation mandates anatomical and functional assessment of the donor kidney. Helical computed tomography (CT) with advanced 3-D techniques provides detailed description of the vascular, parenchymal, and collecting system.

METHODS

We compared the accuracy of helical CT angiography with intra-operative findings in the evaluation of 102 live kidney donors.

RESULTS

Identification of vascular anomalies was best on direct viewing of the axial images using interactive scrolling through the images and cine-loop paging. In 204 kidneys evaluated, a single renal artery was present in 74.5% and a single renal vein in 87.5%. Multiple renal arteries were more common on the left side (31%) vs the right side (20%). Early branching of the arteries was seen with equal frequency (approximately equal to 10%) on either side. Multiple renal veins were more often on the right side (20%) vs the left side (5%), and one patient was found to have double inferior vena cava. CT angiographic findings were concordant with the intra-operative findings in 97% of the cases, missing a small renal vein, an accessory artery that was visualized in retrospect, and a very early branch that was read as accessory artery. CT also revealed cortical cysts (four cases), duplex collecting system (two cases), hydronephrosis (one case), renal stone (one case), and liver haemangioma (two cases).

CONCLUSION

CT angiography is highly accurate for detecting vascular anomalies, and providing anatomical information. It may serve as the primary tool for donor evaluation.