No abstract

No abstract

Background:In March 2013, cases of acute hepatitis were reported from Lalkuan, Nainital district. We investigated the outbreak to identify the source of infection and to facilitate control measures.Objectives:To study the distribution of hepatitis cases, to find the source of infection, and to initiate the control measures in the affected area.Materials and Methods:We defined a case of acute hepatitis as those cases that had jaundice with at least one of the following symptoms: Dark urine, fever, pain in abdomen, vomiting, and loss of appetite in the affected area between January and March 2013. Door-to-door survey was carried out. Thirteen blood samples were randomly collected from jaundice cases for immunoglobulin M (IgM) antibody for hepatitis A virus (HAV) and hepatitis E virus (HEV). Water samples were collected to test residual chlorine.Results:Total 2,785 individuals were surveyed; of which 240 were suffering from acute viral hepatitis (attack rate (AR) = 8.61%). Out of 13 serum samples, 10 were found positive for HEV IgM antibodies and three cases had IgM antibodies for both HAV and HEV, which confirmed a hepatitis E outbreak. The difference in attack rate of hepatitis of both the sexes was statistically significant (P < 0.001). The attack rate was significantly higher in age groups >12 years of age (P < 0.001). Environmental investigation also confirmed the sewage contamination of drinking water in the distribution system. The attack rate was much higher (29.4%) among those who were exposed to the leaking pipeline than the nonexposed (χ2 = 574.26, P < 0.01).Conclusion:HEV was confirmed as the major etiological agent in this outbreak that was transmitted by contaminated drinking water. The recognition of early warning signals, timely investigation, and application of specific control measures can contain the outbreak.

A cross-sectional study was conducted to assess the bacteriological quality of water in Haldwani block, Nainital District, India. Stratified random sampling was used to categorize water sources and consumer points. In total, 108 samples were collected: 15 from the Gola river, 51 from water taps, 24 from water treatment plants and 18 from tube wells. Samples were tested for coliforms by the most probable number technique. Identification of species was done by standard procedures. Of 108 water samples, 58.8% were found to be polluted. All samples of water (n ¼ 15) from different sites of the Gola river were found to be highly contaminated. Out of 24 water treatment plant samples, four samples were found unsatisfactory, while more than half (51.6%) of its supplies to water taps were polluted. From tube wells and their water taps, 88.8 and 60% samples were found safe for drinking respectively. Bacterial contamination of water treatment plants and their supplies indicates significant disparities in the efficiency of water treatment processes. Contamination of water taps of tube wells suggests leakage of pipes. There is an urgent need to improve these services to ensure the supply of safe water for consumers.

public health indicators and/or weak infrastructure. Uttarakhand is one of these. The first contact of village community with a medical officer occurs at a primary health center (PHC). The PHCs were envisaged to provide an integrated curative and preventive health care to the rural population with emphasis on preventive and promotive aspects of health care. The PHCs are established and maintained by the state governments under the Minimum Needs Programme/Basic Minimum Services (BMS) program. As per minimum requirement, a PHC is to be manned by a medical officer supported by 14 paramedical and other staff. It acts as a referral unit for six subcenters and has 4-6 beds for patients. The services provided through PHCs are curative, preventive, promotive, and family welfare services. [1] These services cannot be provided in an efficient and effective manner to the rural population without the presence of a medical officer. Background: As 70% of population of India resides in rural areas, there is need of providing effective health care to people in these areas. Health care system in rural areas faces the challenge of shortage of doctors. Understanding of perceptions and attitudes of medical students toward working in rural areas can help in addressing the problem of shortage of doctors in these areas. Objective: This study aimed to determine the attitude of medical students toward serving in rural areas and the determinants of such attitude. Material and Methods: A cross-sectional study was conducted among 115 medical students of final year and internships of a government medical college. A pretested self-administered structured questionnaire was used for data collection. Descriptive statistics such as percentages, mean, and standard deviation were used for data summarization and presentation. Results: The overall average of the total score of respondents' attitudes toward the working in rural areas was 45.20 and the SD was 7.76, indicating a slightly negative attitude toward the working in rural areas. Students belonging to rural areas had more favorable attitude to working in rural areas in comparison to students from urban background. Conclusion: Medical students had positive attitude regarding the importance of working in rural areas, but their overall attitude toward working in rural areas was found to be not favorable.