81 research outputs found
DOTS for TB relapse in India: A systematic review
No full textIn India, under the Revised National Tuberculosis Control Program (RNTCP), the percentage of smear-positive re-treatment cases is high. The causes of re-treatment include relapse of the disease after successful completion of treatment, treatment failure, and default in treatment. RNTCP does not follow up the patients for any period of time after successful completion of treatment to determine whether they relapse. Given the high cost of treatment for each patient under RNTCP and the potential for spread of disease from these patients, it is crucial for the success of the program and control of the disease in the country to find out more about the reasons behind this. T0 o conduct a systematic review of literature and determine evidence regarding recurrence of TB after its successful treatment with standard short course chemotherapy under DOTS guidelines. T0 en databases were searched including Medline, Cochrane database, Embase and others and reference lists of articles. 255 papers resulted from these searches. Seven studies were finally included in the review after applying the inclusion, exclusion and quality assessment criteria. R0 elapse rate is high (almost 10%) in India which is higher than international studies. Majority of relapse cases present soon after completion of treatment (first six months). Risk factors for relapse included drug irregularity, initial drug resistance, smoking and alcoholism Sex and weight were not risk factors in India. The outcome of relapse cases put on treatment is positive but less effective than new cases. There are sound arguments and sketchy evidence that DOTS Category 2 treatment may not be adequate for retreatment patients
Overwork Among Residents in India: A Medical Resident′s Perspective
No full textThis paper argues that medical residents who do most of the hard work in big hospitals and medical colleges are overworked. A hierarchical organizational structure, staffing patterns, and fear of failure in examinations leads to overwork among residents going unreported. This can lead to poor academic performance and research work. Gaps in communication have serious implications on patient health. Undesirable practices like LAMA (leave against medical advice) also result from overwork. Issues of pay and contracts including mandatory service need to be looked into carefully. National and international recommendations on work hours have consistently been ignored. The solutions suggested are simple and easy to implement
Future of healthcare in India: lessons from Scandinavia
No full textIntroduction: - this study aims to explore the possibilities in improvement of the existing healthcare system of India by learning from a Scandinavian country - Denmark. Methods: - we used the WHO’s framework for assessing performance of health systems. Results: - We discussed under the heads of financing, provision, resource generation (human, physical and knowledge) and stewardship. We compared and contrasted Indian and Danish circumstances and found similarities and differences.Conclusions: - we opine that since Danish health care system is acknowledged to provide good “value for money”, the opportunity of learning from it is great. Naturally, suitable changes need to be made for Indian context and given the size of India these policy changes will have massive ramifications
Developing a Universal Threshold Determination System for Use in Framing Climate Preparedness and Adaptation Policy
No full textParticipatory Modeling of Climate Change Impacts on Public Health in Long Beach, California: Discussion from a Workshop Hosted by the RAND Frederick S. Pardee Center for Longer Range Global Policy and the Future Human Condition
No full text
- …
