A community based survey of coronary heart disease (CHD) was carried out on a random rural sample of 3375 adults in the age group 25-64 years in gurgaon district (Haryana) about 50-70 Km. Away from Delhi. CHD was diagnosed either (a) on the basis of clinical history supported by documentary evidence of treatment in a hospital or at home of (b) on ECG evidence in accordance with minnesta code. The overall prevalence rate of CHD on clinical history basis was 5.9 (7.4 in males and 5.1 in females) per 1000 adults in the age group 25-64 years. Increased number of cases were found in the age group 55-64 years both in males and females. The prevalence rate based both on clinical history and ECG criteria is estimated at 27.1/1000. Risk factors for CHD such as hypertension, smoking, family history, obesity and physical activity were studied.

Outbreak of malaria had occurred in the months of September to November 1988 amongst the residents of village mandal, taluka viramgam, district ahmedabad. As compared to September-November 1987, significant increase in annual blood examination rate (ABER) and slide positivity rate (SPR) was observed in 1988 (September-November). 88 deaths occurred due to malaria from August to December 1988. Mortality rate was more amongst children and people of the lower class. Case fatality rate (CFR) was maximum (11.45%) in October 1988. But due to intensive measures it decreased to 1.47% in December 1988. Appearance of breeding places of mosquitoes due to heavy rains after three consecutive droughts, inadequate surveillance, mosquito resistance to insecticides, plasmodium resistance to drug treatment may have led to this outbreak amongst the residents of village mandal.

Hospital records of kasturba medical college hospital, manipal, Karnataka from 1975 through 1986 were analyzed for cancer admissions. The study period was grouped into two halves. A significant rising trend of proportional case rate of cancer admissions was observed between the two halves. When the cancer trends by site was studied, a rising trend was seen only in cancers of breast, lung, bladder and colorectal region, whereas a declining trend was noted in cancers of orpharyngeal region and that of the uterine cervix. There was a general male predominance in all cancer cases with M.F. ratio of 1.6. In males the most common type of cancer was of the oropharyngeal region and in females, of the uterine cervix.

Effectiveness of community-based leprosy control operations spanning almost a decade in two locations, a small self settled leprosy colony (I) of about 800 subjects as well as a large slum (II) with a population of about 20,000 in the metropolitan city of Bombay are compared. New case detection through survey in location I and voluntary reporting in location II during the period 1982-86 is taken as an index of the impact of the intervention, which consisted of field based administration of multi-drug therapy. Though the leprosy colony concentrates an abnormal reservoir of infectious cases in a small population, it was relatively easier to achieve success in reducing the transmission rate through field-based chemotherapy programme. The same degree of success however, could not be achieved in a normal slum. Health care delivery system in relation to leprosy eradication at the grass-root levels has to be planned giving maximum importance to cost-effective methods of identification of multi-bacillary leprosy patients and monitoring their movements carefully during the treatment phase.

Dewesternisation/demystification/deprofessionalization of medicine denotes the efforts that are made to makes health service meaningful and within the easy reach of the common man. There have been many attempts in India to alter the health delivery system based on western medicine. The first was the licentiate degree. Although the licentiate system was stopped and the training of paramedical workers is not as fast as it should have been, still the attempt is to deliver health care in rural areas through paramedical workers. Community health volunteer scheme is yet another innovation in dewesternising health care, as is the anganwadi worker in the I.C.D.S. scheme. All these attempts at dewesternising medicine have met only with limited success because of the value system in the medical profession and the rural urban dichotomy that exists in the country.

A knowledge, attitude and practice (KAP) study of the family welfare programme was conducted in lahaul & spiti, a tribal district of himachal pradesh. The awareness, attitude and acceptance of the programme was 80.52%, 76.19% and 46.32% respectively. Awareness and acceptance were significantly proportional to socio-economic status. The role of education, motivation and effective communication based on local culture was stressed in this study.

To find out the prevalence of clinical diagnosable neurological disorders three important symptoms were used for screening of patients. These were convulsions, paralysis and chronic headache. The field workers were explained how to enquire for these symptoms in the community. Those who were screened positive by them were later examined by the investigators. The prevalence of common disorders was found to be as follows, chronic headache was more prevalent in females above the age of 15 years, the prevalence being 30.9/1000 females. Paralysis, which was mostly represented by post polio residual paralysis, accounted for a prevalence of 7.2/1000 in males and 6.6/1000 in females. The prevalence of convulsions was 3.2/1000 in males and 8.5/1000 in females.

Chlorination of wells water by the use of bleaching power is one of the most simple and cheap methods of assuring safe potable water in rural areas. The multipurpose health workers are entrusted with this task. These health workers were interviewed with a semi-structured open-ended schedule and their working was observed by work-study to know the difficulties faced by them during the process of chlorination. Majority of the workers were of the opinion that daily chlorination of wells during an outbreak of gastroenteritis in their respective areas was not feasible within the resources available at the block level. The main difficulties faced by them were the large number of wells and inadequate equipment for chlorination. The work-study revealed that most of the workers did not follow the correct method of chlorination and this invariably resulted in super-chlorination of well water thereby decreasing its acceptability by the community. The involvement of local volunteers could be possible solution in rural areas.