Objectives: To evaluate the Revised National Tuberculosis Control Programme (RNTCP) through assessment of performance, response and outcome of treatment of patients. Study Design: Cross-sectional observational study. Materials and Methods: In Domjur Tuberculosis Unit of Howrah district, West Bengal. Two hundred and eighty-six cases registered in the first two quarters (1 January to 30 June 2001) were selected for the study. Data were collected by review of records from all peripheral health units with a pre-designed and pre-tested schedule. Results: Sputum-positive among chest symptomatic were 89 (11.5%). Overall 78.3% were new cases and among them 67.1% were pulmonary, 48.4% were sputum-positive among new pulmonary cases detected. Sputum conversion rate of new sputum-positive cases at 2 or 3 months was 74.2%. Cure rate for new sputum-positive pulmonary TB cases was 53.8% and out of all smear-positive cases was 56.5%. Default among new smear-positive cases was 24.7%. Conclusion: Low sputum conversion rate after intensive phase of treatment, high defaulter rate and low cure rate among new sputum-positive cases in comparison to RNTCP norm have been reflected in this study.

Background: Malaria was and is a major scourge in India contributing more than three-fourths of the total cases in the Southeast Asian (SEA) region. Malaria is largely infl uenced by the local environmental conditions but can be kept in check if the operational implementation of the National Antimalaria Program: (NAMP) is effective. Keeping in mind the context of the situation in Gujarat, there was an urgent need to carry out a study to assess the operational aspects of the ongoing malaria control program. Objectives: To assess the operational aspects of NAMP in "highrisk" areas of rural Vadodara, seeking bottlenecks and possible correlation to the malaria situation in those areas. Materials and Methods: From 269 "high-risk" villages, 20 villages were selected randomly from 10 Talukas. 40 slide (smear-)-negative, 19 slide (smear-)-positive, 10 laboratory technicians, 10 MultiPurpose Workers (MPW) Supervisors and 18 MultiPurpose (MPW) and 18 Voluntary Workers were interviewed. The performance of the malaria clinic and the NAMP staff was evaluated using a point system. Results and Conclusions: The monthly blood examination rate (MBER) targets could not be achieved in 8 out of 10 primary health centers (PHCs) by active surveillance workers (AS) workers. The mean time interval between blood smear collection (BSC) and its receipt in the laboratory was 7.1 days. 46% of smear-negative patients having received presumptive treatment (PT) and 22% of smear-positive patients receiving radical treatment (RT) were supervised. Administration of "adequate" presumptive treatment and radical treatment to the above two sets of individuals was 65% and 58% respectively. Overall, the performance of 50% of malaria clinics and 94% of villages was poor to average. The study has found enough evidence to conclude that there were lapses in the operation of the NAMP.

Research Question: What are the health-related problems of the aged and why do they feel lonely? Objective: To study the health-related problems and loneliness among the elderly in different micro-environment groups. Participants: Aged persons of age 65 years and above. Setting: Urban and rural area of Chandigarh. Design: Cross-sectional. Statistical Analysis: t-test and Z test. Results: During the study, it was found that out of the total 361 aged persons of Chandigarh, 311 (86.1%) persons reported one or more health-related complaints, with an average of two illnesses. The illness was higher among the females (59.5%) as compared to males (40.5%). The main health-related problems were disorders of the circulatory system (51.2%), musculoskeletal system and connective tissue (45.7%). It was also found that loneliness was prevalent more in females (72.8%) as compared to males (65.6%). Loneliness was more prevalent among persons who lived alone (92.2%) as compared to those who lived with their spouse (58.9%) or when husband and wife lived with the family (61.4%). It was higher among the widows (85.2%) and widowers (75.8%) who lived with the family as compared to the aged who lived with the spouse (58.9%) and the aged husband and wife who lived with the family (61.4%). Conclusion: Special geriatric services should be started in the hospitals as the majority of the aged have one or more health-related problems. The aged persons should be involved in social activities to avoid loneliness among them.

Objective: To investigate the causes and contributory factors of perinatal mortality by verbal autopsy in Maharashtra. Materials and Methods: Rural and urban areas in six districts in Maharashtra were selected by Probability proportional to size sampling. Verbal autopsies for perinatal deaths were conducted using standard tools and by visiting households; cause of death was assigned according to the International Classification of Diseases-10 using a standard algorithm. Statistical analysis was done using the SPSS-11 version software. Results: A total of 83 perinatal deaths (31 stillbirths and 52 early neonatal deaths) were investigated out of which cause of death for perinatal deaths could be assigned in 96.4% deaths. The leading causes of perinatal deaths were prematurity (19.3%) and complications of placenta, cord and membranes (12.9%) among stillbirths, while low birth weight (36%) and prematurity (26%) accounted for early neonatal deaths

Objective: To study the effect of various maternal factors on the prevalence of underweight and stunting among 1-5-year-old children in urban slum population. Design: Cross-sectional study. Materials and Methods: The study was carried out in three urban slums of Tripuri Town, Patiala. All 1-5-year children living in these slums were included, whose mother's demographic profile, weight and height were recorded. Results: Out of 482 children who participated in the study, 185 (38.38%) had low weight for age whereas 222 (46.06%) had low height for age. Both kinds of malnutrition were common in females than in males. Prevalence of malnutrition was more where mother's age was less than 20 years. Children of educated mothers were better nourished as compared to illiterate ones. Conclusion: Maternal factors significantly affect a child's nutritional status, thus encouraging the improvement in the social status of women so as to have healthy children and thereby a healthy future.

Background: Vehicular pollution is increasing in Indian cities, which may lead to increased number of patients with diseases related to air pollution. Present study was undertaken to assess the pattern of morbidity in two areas of Delhi, one highly polluted area (HPA) and the other low polluted area (LPA). Materials and Methods: Subjects were interviewed regarding socioeconomic status and exposure history. Symptoms during the last month were recorded in a questionnaire and weight, height and peak expiratory flow rate (PEFR) were measured. Air pollution data were obtained from the monitoring stations of Central Pollution Control Board (CPCB). Results: A total of 640 subjects participated in the study. Majority of the patients in both the areas were educated till primary but 24% in HPA and 13% in LPA were graduates. Current levels of all pollutants (except SO2 and NOx) were above the safety levels prescribed by CPCB in both the areas, but the values were much higher in HPA. The values of PEFR amongst study population were more compromised in HPA. The difference in mean PEFR values among the populations in LPA and HPA were found to be statistically significant (P < 0.05). The mean number of symptoms experienced by subjects of HPA was more as compared to LPA (P < 0.05). Frequency of occurrence of symptoms varied with duration of stay in the study area. Children were affected more than the adults. Conclusion: Air pollution has a deleterious effect on various systems of the body.

Objectives: (1) To assess the magnitude of the problem of low birth weight (LBW) in a rural area of Haryana (2) To study the association of caloric and protein intake in third trimester of pregnancy with birth weight. Study Design: Longitudinal study. Sample Size: One hundred and forty pregnant women. Study Area: Ten purposively selected villages in the rural area of Naraingarh block in Haryana. Study Tool and Data Collection: Pre-tested questionnaire was administered to record information regarding socioeconomic status, antenatal care, nature of physical activity and dietary intake in 24 h between September 2001 and August 2002. Data Analysis: For categorical variables, Chi-square test was used, and for numerical variables, t-test was used. Multivariate analysis was done for variables that were significant in bivariate analysis. Results: The prevalence of low birth weight (less than 2500 g) was 24.3% (95% CI 17.4-32.2%). The mean caloric intake during three dietary assessments was 1695 ± 182.8 kcal. The mean protein intake during three dietary assessments was 50.8 ± 9.27 g. The higher prevalence of LBW babies was observed in pregnant women with mean caloric intake of less than 1500 kcal and mean protein intake of less than 40 g (P < 0.001). In multivariate analysis, the association of caloric intake (P < 0.01) and weight of the mother (P = 0.02) was independently associated with LBW. Conclusions: Low caloric intake in the third trimester of pregnancy and maternal weight are significantly associated with the birth weight of babies.