Objectives : To ascertain time taken for cataract surgery by ophthalmologists in the National Capital Region of Delhi and neighbouring districts, to determine what work output is feasible with the available ophthalmologists. Methods : The time-motion study was conducted during January to June 2006 in the National Capital Region of Delhi and neighbouring districts in North India. Data was collected by observing all activities from entry of a patient into the operating theatre to exit. A total of 156 cataract surgeries performed by 45 ophthalmologists in 38 hospitals were observed. A stop watch was used to record activity time, rounded off to the nearest 10 seconds. Case duration, surgical and clinical times were calculated. Results : Ninety percent ophthalmologists completed surgery in 41.3 minutes. The 10 ^th and 90 ^th percentile for case duration time was 15.5 and 78.4 minutes respectively. Median surgical time was lowest for ophthalmologists working in the NGO sector (10 minutes), compared to the government (23.5 minutes), and private sector (17.3 minutes). Cataract surgical output can be increased in the country if operation theatre time is utilized optimally.

Objectives & Methods: A training programme in population-based research was introduced for interns in 1993, in a Delhi medical school. Guided by the persistent feedback from learners, the timing of such training was advanced to MBBS para-clinical phase in 1999 - integrated with 10 months first slot of community medicine posting. Present article analyzes learners' feedback on this newly designed training programme from 16 consecutive batches from 2002-2006. Results: In 7 of the 9 units of learning, around 90% of the students rated their participatory involvement at >=3 points on a 5 point rating scale. This rating was best in data collection (97.8%); and identification of research question (97.6%) - and least in presentation of report (48.7%); and report writing (61.8%). For 77.6% of the students, this was their first hands-on experience in population-based research. Over 55% of the students expressed their willingness to maintain their interest in population-based research after finishing the community medicine posting. On the other hand, 22.6% distinctly expressed their unwillingness in this regard. Main reasons cited by unwilling/not sure students were: 'low level of personal interest in population-based research' (39.7); 'such activity was not contributory in getting admission to postgraduate courses' (33.2%); and 'Not so useful in likely job responsibilities' (21.2%). Almost half (48.9%) of the students chose para-clinical phase as most suitable period of MBBS for such learning exposure. Pre-clinical; clinical; and internship phases were preferred by 19.7%, 13.9%, and 10.7% respectively. Conclusion: Present feedback provides us a broad direction in opting for the para-clinical phase where exposure to population-based research can be effectively placed on a systematic basis, without extra resources.

Introduction: An epidemic of viral hepatitis occurred in Mandi Gobindgarh town of Punjab in northern India during year 2005-06. An attempt was made to study the outbreak clinically, serologically, and etiologically. Methods: Line listing and spot mapping of all cases of jaundice presented to civil hospital was done. An active search of cases was made through house-tohouse visit with the help of 33 teams and 6 supervisors. Twenty two blood samples collected from acute cases were tested for anti-HAV IgM and anti-HEV IgM by ELISA. HEV specific PCR was also carried out. Sanitary survey was also done and water samples were tested for coliforms. Results: In house to house survey 3170 cases of jaundice were reported; of them 2171 (68.5%) were males. Mean age was 28.8 years. Overall attack rate was 5.2%. The epidemic continued for more than a year and bimodal peak was observed. Civil hospital campus which has separate water supply had no jaundice case. About 95% blood samples from icteric patients were found to be positive for IgM and IgG antibodies of HEV. Eighteen persons died during the epidemic, mostly in old age group. Case fatality ratio was 0.57%. No deaths occurred among 17 pregnant women who had developed hepatitis. Conclusion: The epidemic was caused by hepatitis E virus, which was transmitted due to faecal contamination of municipal water supply.

A cross sectional study was conducted among 423 victims of road traffic accidents reporting to Indira Gandhi Medical College, Nagpur for treatment during 1999-2000. Data was collected on pre-designed proforma by interview technique. Majority of the victims were male (85.8%) and of 18-37 years (74%); 64.5% of the subjects were consuming alcohol regularly and 5.9% were drug abusers; 43.7% and 10.2% had visual and hearing impairment respectively; 43.5% were not having any driving experience and 74.4% of the victims with two wheelers were not using any helmets at the time of accidents. Findings highlight the need for sustained health education and enforcement of traffic laws.

A retrospective survey was conducted during August to December 2007 in 19 medical colleges of India to examine the functioning of the PPTCT service delivery. Data was extracted from records of the PPTCT centers for the year 2005-2006. HIV prevalence was higher than 2005 NACO figures in 11 out of 19 (57.8%) centers. There was wide variation in the proportion of women counseled & tested for HIV in different centers. Antenatal prophylaxis was practiced in 7 out of 19 (36.8%) centers. Overall intra-natal ART was provided to 52.8% of HIV positive women. Early newborn testing was available at 3 out of 19 (15.7%) centers. Improved counseling services are required for better case detection.

Undernutrition among tribal children is a major public health problem in India. Our study attempted to evaluate the prevalence of malnutrition among Lodha children of Paschim Medinipur, West Bengal. A cross sectional study was conducted among 165 children aged 1-14 years in a village of Paschim Medinipur district during January to March 2008. Children were considered underweight, stunting and wasting following the NCHS standards. Overall the prevalence of underweight, stunting and wasting was 33.9%, 26.1% and 19.4 %, respectively. Of these, 9.1%, 9.7% and 3.6% children were found to be severely underweight, stunted and wasted. Moreover, the prevalence of underweight and stunting was significantly higher in pre-school children compared to school going children. There is an urgent need for appropriate steps to be taken to improve nutritional status of children in this ethnic group.

Previous studies have demonstrated that tribal children suffer from a higher rate of morbidity. Gender discrimination in the form of dietary neglect of the female children has also been noted. The community based cross-sectional study was carried out in tribal PHC Salona of Chikhaldara Block, Amaravati District, Maharashtra to study the prevalence and pattern of morbidities in children. 2603 study children between 0-72 months of age were covered in a house to house survey by the investigator. Parents of eligible children were interviewed using a pre-tested questionnaire for socio-demographic details, personal habits, past and current medical history. The prevalence of overall morbidities was 34.7% and it was higher in female as compared to male children (34.8% vs. 29.7%; χ2 = 9.3, p < 0.005). Among individual morbidities, the prevalence of acute respiratory infections was the highest (25.5%) followed by acute diarrhoeal diseases (5.8%), conjunctivitis (1.5%), and skin infections (1.2%).

A descriptive study was conducted among tetanus cases admitted to epidemic disease hospital (EDH), Bangalore from October 2006 to March 2007 to describe the socio demographic characteristics of tetanus cases, the clinical presentation and the treatment given to tetanus cases. A total of 80 cases were admitted during this period. Out of the 80 tetanus cases, 71% were from rural area, 55% unimmunized, 47.5% were agricultural workers. A total of 25(31.25%) deaths were observed during the study period. No case was administered anti tetanus serum outside the epidemic disease hospital.

The intricate pattern of parenting in our socio-cultural context needs evaluation hence this study was done with the objective to reveal the parenting styles of school going children. 141 school children belonging to the age group 6-10 years were included in the study. The Parental Handling Questionnaire a 14-item scale consisting of 10 items of care and 4-items of control was administered to the mothers accompanying the children. Rating was done on a 3-point. The scale showed moderate internal consistency. 5 independent factors with overlapping items of care and control were deduced on factor analysis indicating multidimensional aspects of parenting in our society.

The present cross-sectional study was undertaken during August- September 2004 in an urban slum area of Pune to find out prevalence & characteristics of physical wife abuse/wife beating & to ascertain women's views & behavior towards it in a social context. The prevalence of physical wife abuse/wife beating was reported to be 61.5%. The most commonly reported husband's behavior included slapping (98.8%) followed by pushing (39.8%) & kicking wives (33.7%). 17.8% women justified physical abuse by husband. The most commonly reported behavior of women included crying (85.2%) & silently bearing the physical abuse (59%).

A community based, cross-sectional study was conducted in the Mollasimla village of Hooghly district of West Bengal, to examine the differences in nutritional status of under-five males and females and to determine the different bio-social factors associated with such differences. It was found that 55.9%, 51.4% and 42.3% of the girls were underweight , stunted and wasted respectively compared to 46.6%, 40.5% and 35.3% of the boys and a significantly higher proportion of malnutrition was found to be present among female children of higher birth order and those belonging to families with lower per capita income compared to the males.

An outbreak of measles was reported from Shivpuri district of Madhya Pradesh, India. The authors investigated this outbreak with an objective to describe the under nutrition and measles related complications. A total of 723 children aged 12-59 months were included in this study. Their caregiver was interviewed for necessary information and Mid Upper Arm Circumference measurement of the affected child was done for the assessment of nutritional status. 171 (22.3%) of these had reported to have suffered from one or more measles related complication. 556 (76%) of the measles cases in this study were undernourished. Measles related complications was more among measles affected children who were severely undernourished (38%) in comparison to other groups (χ2 = 97.80; d.f. =1; p<0001).

It is estimated that 10-15% of the population has chronic kidney disease (CKD), resulting in significant health expenditure, which is largely met by out-of-pocket by the patient in India. However, the seriousness of this public health problem has remained largely under-recognized so far. Luckily the preventive measures are simple and not difficult to implement. Public health strategies are essential to control the burgeoning problem. Lifestyle modifications can reduce the incidence of obesity, hypertension and diabetes. These diseases account for a significant proportion of CKD cases. Active involvement of the primary care physicians is vital for early detection of CKD with retardation of its progress, since nephrologists do not see the patients in the early stages. The role of community health specialists is essential to organize health education programs and screening camps, form active patient support groups; and incorporate the prevention program in the various tiers of the health-care system. Availability of optimal nephrology services in peripheral hospitals can rehabilitate most cases of end-stage renal disease, and also prevent the illegal organ trade, which keeps rearing its ugly head at regular intervals in India.