There are 11.1 million children in the age group 0-6 years in West Bengal. Of these, every second child under 3 years of age is underweight, more than four out of ten are stunted, and one out of eight are wasted. The Integrated Child Development Services (ICDS) programme in West Bengal has 355 operational projects covering 53,064 operational anganwadi centers reaching out to more than four million beneficiaries-approximately half of whom are children in the age group 0-3 years. The Department of Women and Child Development (DWCD) is trying to identify and replicate innovative, community-based, sustainable approaches. One such innovative initiative has been the " Keno Parbo Na " project. based on the Positive Deviance (PD) approach which aims to reduce and prevent malnutrition among children under 3 years of age by focusing on local solutions and resources, local behaviors and practices. Behavior change is emphasized through participatory learning and community mobilization. The pilot phase of the project has been completed in two districts [Four blocks (2 in each District) and 32 villages/AWCs (8 in each block)] of West Bengal (Murshidabad and South 24 Parganas). The analysis of the project activities so far reveals that the issue of malnutrition and its prevention is now visible in the villages covered. Acceptance of desirable behavioral practices is observed within the community. A steady reduction in the moderate and severe level of malnutrition was noted across four districts. A general preponderance of girl children was noted at the entry stage indicating higher levels of severe and moderate malnutrition among girl children to begin with but also suggesting PD as an important strategy in reducing the gender gap in malnutrition. The boys gain in terms of nutritional status faster than the girls so in the intermediate phase malnourished girls are more in number. However, by the sixth / ninth round, as the malnutrition levels decline substantially, the gender gap tends to close.

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With the objective of assessing the level of awareness about the various aspects of biomedical waste and disposal practices by the medical practitioners this study was conducted. It was a cross sectional study. 30 hospitals with more than 30 beds minimum were randomly selected from Sabarkantha district, Gujarat. The doctors and auxiliary staff of those 30 hospitals were the study population. While all the doctors knew about the existence of the law related to biomedical waste but details were not known. Doctors were aware of risk of HIV and Hepatitis B and C, whereas auxiliary staff (ward boys, ayabens, sweepers) had very poor knowledge about it. There was no effective waste segregation, collection, transportation and disposal system at any hospital in the district. There is an immediate and urgent need to train and educate all doctors and the staff to adopt an effective waste management practices.

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In the present study anthropometric measurements showed that all the children of scheduled caste families under investigation were under weight and suffered from protein energy malnutrition, night blindness, angular stomatitis, enlargement of liver, anaemia, spongy bleeding gum and a few cases of bow legs, polio and keratomalacia. The haemoglobin level was below World Health Organisation (WHO) standard. Their intakes of protective foods and nutrients such as energy, calcium and iron were less than respective recommended dietary allowances (RDA). Socio-economic environment is responsible for poor nutritional status ofscheduled caste pre-school children.

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Malnutrition is an important Public Health problem globally as well as in India. Mortality is a multi-causal phenomenon in which malnutrition is but one factor directly or indirectly contributing 55% mortality of children under-five years of age. Authors observed higher prevalence of severe degree of Malnutrition in the underserved section of population with specific reference to girl child, under 3 years of age, where there were large number of children in the family, repeated infections and Measles. Growth monitoring Services in the ICDS scheme meant only weight recording and was not at all satisfactory. Even the majority of the Anganwadi workers (AWW) stated that it meant monthly weight recording of children while only few knew it is in addition plotting these on growth charts and advising mothers if growth was not proper. Around 60% of caregivers did not know about growth monitoring. The concept of growth monitoring should be changed to Growth surveillance to emphasize more on the action components of it.

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A community based cross-sectional study was conducted in reproductive age group women in an urban community of Nagpur, to assess the prevalence of leucorrhoea & the factors influencing the same in these women. The study participants included 506 females, out of which 149 were unmarried & 357 were married. Detailed history & clinical examination was done in all the females including gynecological examination in all the married females. Leucorrhoea was present in 139(27.47%) females. Leucorrhoea was found significantly more in married females as compared to unmarried (p<0.001), pregnant as compared to non-pregnant (OR=2.10,95% C.I.=1.02-4.32), & women of lower socioeconomic status (p<0.001), women with high parity (p<0.001). Use of Cu-T was not associated with Leucorrhoea (p>0.05).

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Rajasthan is the largest state in the country frequently affected by droughts. The year 2002 happened to be the fifth consecutive year of drought. Almost all districts of the State were hit by it. The district of Baran located in South-East of Rajasthan has 'Sahariya' tribal population concentrated in its Kishanganj and Shahabad blocks. Press reports of starvation deaths amongst tribal children in these blocks created a stir in the local district and the State Government set ups. The paper describes an objective and professional approach to deal with the situation. Rapid nutritional assessment indicated very high prevalence of severe under weight (28.3%) and wasting (4.7%) amongst under five children. Nutrition Care Centres (NCC) were set up in selected villages to provide targeted feeding and care to these children as per WHO guidelines. Local 'Sahariya' community was involved to run these NCC. Intensive public education campaign was carried out to promote improved child caring practices and referral of malnourished children with complication to hospitals. Orientation of press and electronic media on factual details regarding the situation helped create an enabling environment to implement remedial measures. The impact of 'Nutrition Care Centres' assessed after six months was found to be positive in terms of reduction in prevalence of under nutrition in children from 66.7% to 59.6%. Successful management of severe malnutrition amongst children by workers at Nutrition Care Centes and in family settings using standard protocols led to the wide scale replication of the approach by Anganwadi centres in different district of Rajasthan. The State Government also created an additional cadre of worker called 'Sahayogini' to support Anganwadi worker and promote better child caring practices at family level.

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The present pair-matched case control study was carried out at Government Medical College Hospital, Nagpur, India, a tertiary care hospital with the objective to devise and validate a risk scoring system for prediction of hemorrhagic stroke. The study consisted of 166 hospitalized CT scan proved cases of hemorrhagic stroke (ICD 9, 431-432). and a age and sex matched control per case. The controls were selected from patients who attended the study hospital for conditions other than stroke. On conditional multiple logistic regression five risk factors- hypertension (OR= 1.9. 95% Cl=1.5-2.5). raised scrum total cholesterol (OR=2.3, 95% Cl= 1.1-4.9). use of anticoagulants and antiplatelet agents (OR=3.4, 95% Cl=1.1-10.4). past history of transient ischaemic attack (OR=8.4, 95% Cl = 2.1- 33.6) and alcohol intake (OR=2.1, 95% Cl=1.3-3.6) were significant. These factors were ascribed statistical weights (based on regression coefficients) of 6,8,12,21 and 8 respectively. The nonsignificant factors (diabetes mellitus, physical inactivity, obesity, smoking, type A personality, history of claudication, family history of stroke, history of cardiac diseases and oral contraceptive use in females) were not included in the development of scoring system. ROC curve suggested a total score of 21 to be the best cut-off for predicting haemorrhag stroke. At this cut-off the sensitivity. specificity. Positive predictivity and Cohen's kappa were 0.74, 0.74, 0.74 and 0.48 respectively. The overall predictive accuracy of this additive risk scoring system (area under ROC curve by Wilcoxon statistic) was 0.79 (95% Cl=0.73-0.84). Thus to conclude, if substantiated by further validation, this scorincy system can be used to predict haemorrhagic stroke, thereby helping to devise effective risk factor intervention strategy.

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Sub acute sclerosing pan-encephalitis (SSPE) is a slowly progressive inflammatory disorder of the central nervous system. A decline in frequency has been noticed in most of the developed countries, whereas it continues to be high in developing countries. Though a number of studies have been carried out, the exact trend of SSPE is still not clear. Hence the present study was carried out to analyze the trend of SSPE over the past ten years in and around Chandigarh. A total of 205 patients with clinical features suggestive of SSPE were enrolled for the study during Jan'92 to Dec. 2001. Measles specific antibodies were detected in blood and CSF by HAI method. 114 patients were found to be positive for measles specific HAI antibody with a male preponderance. The number of SSPE cases were found to be more during the period 1992-95 in comparison to the next 6 years (p< 0.05). The high incidence of SSPE in our country could be due to improper vaccine coverage, poor cold chain maintenance or circulation of atypical measles virus strain.

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This study was carried out among the Private Allopathic Medical Practitioners (PMPs) at Khardah Municipal area (West Bengal) to find out their perception & practice about management protocol of diseases like acute respiratory infections and diarrhoel diseases in children, malaria and tuberculosis. Data was collected by interviewing the PMPs with predesigned open-ended questionnaire. It was supplemented by analysing sample prescriptions of the same diseases. The study revealed that PMPs knowledge and practice were not at par with national guidelines. The need for periodic sensitization of PMPs regarding national disease control programme was emphasized.

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A series of Community Psychiatric Clinics were conducted in different blocks of Sundarban region of West Bengal. One of the primary objectives of this was to collect clinical epidemiological data on psychiatric morbidity in the region. A total of 26 clinics were conducted in Sagar, Kakdwip, Canning and Gosaba block of the Sundarban region during the period from end 1998 to end 2000. A total of 451 psychiatric cases with diagnostic categories (male 239, female 212) and 215 non-psychiatric cases (male 107 and female 108) were seen in these clinics. Diagnostic Interview Schedules (SCID) and Clinical rating scales like Hamilton Depression Rating Scale and Brief Psychiatric Rating Scales were used to ascertain clinical diagnosis quantitatively. Special emphasis was given on common psychiatric disorders.

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A retrospective analysis of childhood Acute Bacterial Meningitis from a tertiary care hospital in Bangalore revealed a winter clustering of cases and an absence of typical signs and symptoms in 40% of patients, with Staphylococcus aureus (10%) and coagulase negative Staphylococcus (9%) being the most common etiological agents. Mortality rate was 8.5%. High priority for the prevention of disease by these pathogens, especially in rural population and during winter, and a high degree of alertness for the detection of atypical disease is warranted.

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A retrospective cohort study was undertaken among 100 women workers of 35-40 years of age to elicit the risk of spontaneous abortion. Comparison was made with a matched control group of 100 non-working women. Employed women were found at increased risk of spontaneous abortion than the control group. The difference was found statistically significant at p<0.05, Odds ratio being 1.50 and AR% being 33.14. According to gravidity also, abortion was found to be significantly raised in working women after their joining service for first 3rd - 4th gravida. The risk then fell, to raise again for 8th or more gravida.

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The study was conducted at Birbhum and Purba Medinipur districts of West Bengal to assess the routine primary immunization coverage following 40 cluster sampling technique was used to study 320 children in each of the districts. BCG coverage was found to be 79.69% at Birbhum and 84.38% at Purba Medinipur. Only 62.81% children at Birbhum and 67.81% children at Purba Medinipur received all the three primary doses of DPT. Regarding OPV, coverage with three primary doses were only 65% and 66.88% at Birbhum and Purba Medinipur respectively. Measles vaccine coverage was very poor at both the districts, 55.94% at Birbhum and 62.5% at Purba Medinipur. Full primary immunization was observed 53.13% and 61.56% in Birbhum and Purba Medinipur respectively. High drop-out rate was identified as a major deficiency in both the districts. Of the children who received at least one routine vaccine, more than 1/3rd at Birbhum and more than 1/4 th at Purba Medinipur did not turn up later for completion of their primary vaccine doses. It is evident that routine immunization coverage was poor in both the districts and it seems there has been no improvement in situation for last few years. It will influence not only the child morbidity and mortality situation but also will jeopardize the paralytic polio eradication programme. Urgent intervention should be undertaken to address the large number of non-immunized children as well as high proportion of drop-outs.

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The recent biotechnological revolution in Molecular Entomology explores new promising tools for the control of vector borne diseases through genetic manipulation of vectorial competence. The gene transfer technology is hoped to make the malaria vectors incapable of supporting the development of malaria parasite which will ultimately lead to eradication of the parasites and the disease.

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A hospital based study was conducted in the anti-rabies clinic of a medical college of Orissa during April 1988 to May 2002. Of 24 clinically diagnosed and reported rabies cases during the four years study period, 62.5% were children below 15 years of age, 67% were males, 87.5% were victims of stray dogs, 79% had not taken any anti-rabies treatment though all had undergone treatment by traditional systems of medicine.

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A cross sectional study was undertaken in three riverine and two non-riverine blocks of South 24 Parganas district, West Bengal to study the delivery practices and compare between two locality. During the reference period of one year, of 3073 total deliveries, 89.36% were home deliveries. Home deliveries were higher in the riverine blocks (95.07%) compared to nonriverine blocks (81.64%). 'Dai' conducted 58.36% and 90.62% of home deliveries in riverine and non-riverine blocks respectively. Only 18.4% of the 'Dai' were trained.

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A record based study was conducted in a rural medical college of West Bengal. Analysis of data for a full calender year (January to December 2000) revealed perinatal mortality rate and early neonatal mortality rate as 128.03 and 31.94 per 1000 live births respectively.

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The study was carried out among the adolescents in respect to their beliefs about sexual behavior and their intended decision with regard to engaging in sexual activity. Both male and female respondents indicated that they believe that individuals of their age should wait until they are older before engaging in sexual activity. However, there were significant differences between the responses of male and female adolescents.

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The study attempted to assess agricultural practices and personal hygiene among 100 agricultural workers in a rural area of West Bengal in 1999. 69% of the study population was marginal farmer with less than 2 acres of land. Organophosphorus group of pesticides were most commonly used pesticides (68%); spraying was irregular in nature (98%), through semiautomatic sprayer (99%) and only 5% used any special dress while spraying pesticides. 40% of workers used to store pesticides either in living room or in food storage area. 88% of them did not take any food during work with pesticides, only 37% used to take regular bath after working with pesticides but regular hand washing was practiced by all of them.

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A clinico epidemiological prospective study was carried out on acute viral infection of brain among children admitted in a rural based medical college from September '99 to Oct '01. Out of 80 cases, 8 cases (10%) of aseptic meningitis, 35 cases (43.75%) of encephalitis and 37 cases (6.25%) of meningo-encephalitis were found. Overall case fatality was 47.5% and found higher (77%) among normally nourished children in comparison to malnourished children(47.5%). Virological investigation did not isolate any known Flavivirus,Herpes Simplex virus(HSV) and Measles virus; nor any serological evidence against these viruses.

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A study was conducted in a non-paying gynaecological ward of the district hospital, South 24 Parganas, West Bengal to assess different bed efficiency indicators. Total 331 patients were admitted in 23 study beds (12 OPD beds and 11 emergency beds) during an observation period of six months. Overall average number of admissions were 14.4 and average length of stay 14.7days. Bed turnover rate was 13.8 and was higher for emergency beds (22.1) compared to OPD beds (9). Bed occupancy rate was 61.3% with significant difference between OPD beds (57.5%) and emergency beds (65.4%).

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