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Background: Our aim was to study the socio demographic determinants of ASHA workers, to study the work profile of the ASHA workers, to assess the knowledge, awareness and practice of their roles and responsibilities in the delivery of health care services and to suggest specific recommendations on the ASHA scheme based on the study findings.Methods: The type of study was a cross sectional study, placed at Khordha district in Odisha. Time Period of this study was March to June 2018. 1218 ASHAs were finally included in the study. On the days of the monthly sector / block level meetings with ASHA workers they were appraised and accordingly a predesigned, pretested questionnaire was implemented to them.Results: Nearly 93% of ASHA workers were trained with module 1 to 5, first AID and DOTs training. Refresher training was given to 34% of ASHA workers, FTD/Malaria training was given to 88.4% of ASHA workers. 1218 (100%) ASHA’s helped in immunization. Majority of them 1199 (98.4%) accompanied delivery cases and 1198 (98.3%) were aware about family planning activities.Conclusions: Activities of ASHA’s should be increased with a corresponding increase in incentives, so that she can get up to Rs. 10000-15000 per month. IEC/BCC skills to ASHA may be built by short course certification. Other services like strengthening the role of ASHA on promotive and preventive health care particularly age at marriage, nutrition, home based care delay in first child birth and spacing between 1st and 2nd birth.

Background: Nutritional status of adolescent girls are different from the younger children and older adults. In the tribal population they are more neglected in comparison to boys because of limited resources and health care facilities. In the present study we have done assessment of nutritional status of adolescent girls in the Dongria Kondh tribe in Odisha. Methods: Dongria Kondh’ residing in Rayagada district of Odisha, having its maximum concentration was studied. Bissam Cuttack block was selected randomly as the study area. Moreover, coincidently majority of the study population resided in the block having villages like Kurli, Khambesi, Hundijali, Muthesi, Khajuri, Mundabali and Uppar Gandatallli which are situated as a distance of 5000 ft height above sea level. 89 adolescent girls were considered to assess the nutritional status of tribal adolescent girls of Dongria Kondh tribe to study the different factors associated with the nutritional status of the girls and to suggest remedial measures for integrated development of the adolescent girls. Results: Most of the girls (81%) were from nuclear family. All girls belonged to low socio economic status. The energy intake was adequate only in 35% of study subjects. The protein intake was adequate in only 38% of study subjects. The common types of food consumed was rice, ragi and seasonal fruits and all were non vegetarian. Conclusions: The widespread problem of poverty, illiteracy, malnutrition, absence of sanitary living condition, ignorance of cause of disease still are the contributing factors for the deplorable condition prevailing amongst the adolescent girls of the tribal group. As they are future mothers, improvement of nutritional status should be the primary objective.

WHO)-UNICEF-World Bank (2015) joint estimate indicates that globally, the numbers of under-five children with wasting have remained high between 1990 and 2014, with the largest proportions of wasted children living in Asia (68.0%) and Africa (28.0%). 2 Odisha has a total population of approximately 42 million and an under-five population of approximately 3.7 million. According to the NFHS -4 conducted in 2015-16, at the national level severely wasted children comprise ABSTRACT Background: Severe acute malnutrition (SAM) places extraordinary challenges in the way of survival, growth and development of the child under five years of age. Our aim was to evaluate the functioning and performance of facility based management of SAM children admitted in the nutrition rehabilitation centre (NRC) and to identify the existing bottlenecks in the NRC. Methods: Children above 1 month and less than 5 years of age with severe acute malnutrition were included during the study period. Demographic details of the SAM children, clinical features during admission were recorded. Anthropometric measurements like MUAC, weight, height/length and WHZ scores were taken at admission and compared with the findings at discharge. Statistical analysis: the data after collection, compilation was analysed by SPSS. Results: Majority 277 (78.47%) of them belonged to rural areas. 300 (85%) SAM children were referred by medical officers. Bilateral oedema was recorded in 12 (17.9%) admitted children during 2014-2015, 22 (17.9%) children in 2015-2016 and in 37 (22.7%) children during 2016-2017. There was significant improvement in the mean weight (kg) and mean MUAC (cm) at discharge was in comparison to the weight and MUAC of the children at admission and this difference in increase in the mean weight and MUAC were found to be statistically significant. Conclusions: Implementation of WHO feeding guidelines resulted in adequate weight gain of inpatient malnourished children, however the frontline workers in the community and health care providers of PHCs should be trained and given hands on training for early identification and referral of SAM cases.

Background and Aims Etomidate, an intravenous (IV) induction agent known for its stable myocardial action, can produce myoclonus which can be detrimental for the cardiac patients. Though lignocaine has proven its efficacy in attenuating the etomidate-induced myoclonus, the ideal dose of lignocaine is not known. The aim of our trial was to analyze two different doses of lignocaine on the occurrence and intensity of etomidate induced myoclonus. Materials and Methods A total of 120 patients were randomly assigned into three groups of 40 each. Patients in group A were injected lignocaine 0.5 mg/kg intravenously, group-B patients were injected lignocaine 1 mg/kg intravenously, and group-C patients were injected saline placebo. After 2 minutes, anesthesia was induced with 0.3 mg/kg of etomidate over 30 seconds. The patients were assessed for myoclonus using clinical severity scoring system during first 2 minutes of induction. Our primary outcome was the incidence of myoclonus. The severity of myoclonus and adverse effects were the secondary outcomes. Results No remarkable variation was found regarding demographic profile among three groups. Incidence of myoclonus in groups A and B was 35% and in group C was 98%, the difference being statistically significant. Both doses of lignocaine reduced the severity of myoclonus up to same extent. Conclusion Pretreatment with IV lignocaine 0.5mg/kg and 1 mg/kg IV remarkably decreased the occurrence and severity of myoclonus induced by etomidate up to same extent.

The study was undertaken to examine the capability of carbohydrate to spare protein in the diet of fringed lipped carp, Labeo fimbriatus (2.93 g±0.15). Three semi-purified experimental diets of iso-caloric nature were formulated having three graded levels of protein (27, 23 and 19% CP) and three levels of carbohydrate (26, 31.5 and 37% CHO). Accordingly, the treatments were designated as T1 (27% CP and 26% CHO), T2 (23% CP and 31.5% CHO) and T3 (19% CP and 37% CHO), where the experimental diet T1 served as the reference diet. The fish were reared in 200 l fibre reinforced plastic (FRP) tanks under continuous aeration with one third water exchanged daily. After 90 days of feeding trial, it was noticed that the percentage weight gain and specific growth rate (SGR) of 27% protein fed group (209.5±0.74% and 1.26±0.15%) and 23% protein fed group (204.8±0.52% and 1.24±0.13%) were not significantly different (p>0.05). Similarly, the results of feed performance like feed conversion ratio (FCR) among 27% protein fed group (2.24±0.11) and 23% protein fed group (2.29±0.14) did not vary significantly (p>0.05). On the other hand, the protein efficiency ratio (PER) and protein productive value (PPV) of 23% protein fed group (1.87±0.11 and 28.34±0.36) did not vary significantly (p>0.05) with the 19% protein fed group (1.93±0.12 and 27.65±0.32). The carcass protein (CP) and lipid (as ether extract,EE) content of 27% protein fed group and 23% protein fed group were not significantly different (p>0.05). Results of this study indicate that the CP level in the diet of fringed-lipped carp L. fimbriatus can be reduced from 27 to 23% by proportionately increasing carbohydrate level from 26 to 31.5% without compromising growth and also without any adverse physiological effect.

Background: As a part of “Swachh Bharat Abhiyaan” campaign, the Ministry of Health and Family welfare, Govt. of India had launched “Kayakalp” in 2015, an initiative to promote cleanliness and enhance the quality of public health facilities. Our aim was to study the situational analysis of the health institution using Kayakalp tool; to assess the level of cleanliness, hygiene and infection control practices in the facility and to assess the status of Bio-medical waste management in the health care facility and to suggest remedial measures based on the study finding.Methods: It is a hospital based snapshot study done during a period of one year from April 2016 to March 2017. Kayakalp assessment tool was used for analysis.Results: The total scores for upkeep maintenance obtained in 2016-17 was 69 and for the year 2017-18 was 81. There was an increase of total score in the year 2017-18 and it was found to be statistically significant. On assessment in the year 2016-17, for BMW the total score obtained was 58 and in the year 2017-18 it was 81. There was a statistically significant increase in the scores (p=0.001) obtained in the year (2017-18).Conclusions: Improvements in Biomedical waste management can be made by increasing the knowledge, awareness and practices of the health care providers as well as the beneficiaries with regular periodic monitoring.

Objective Our aim was to estimate the occurrence of adrenal suppression in critically ill patients with septic shock who have got admission in intensive care unit and to evaluate the effectiveness of hydrocortisone in these patients in relation to mortality of patient, development of septic shock, and effect on total leucocyte count. Methods Serum cortisol was measured in 120 patients with sepsis. Patients with decreased cortisol level were split in to two groups (group A and B). Group A received 50 mg of hydrocortisone 6 hourly and group B was given matching placebo. At day 7, serum cortisol level was estimated for both A and B groups. The results were calculated and compared with relation to incidence of adrenal insufficiency, development of septic shock, effect on total leucocyte count, and survival at 28 days. Results The occurrence of adrenal suppression in patients having sepsis in our study was 44 out of 120 patients, that is, 36.6%. After supplementation of corticosteroid for 7 days the mean value of serum cortisol of group A was 40.38 ± 8.44 µg/dL and group B was 24.30 ± 6.47 µg/dL (p < 0.001). At day 7, in group A, 22.7% developed septic shock, whereas in group B, 36.4% developed septic shock (p < 0.001). In group A and B, mortality rate of the patients at 28 days was 18.2 and 22.7%, respectively. Conclusion Hydrocortisone supplementation in critically ill patients with low random basal serum cortisol level with sepsis does not significantly improve the overall survival.