To widen access and improving the quality of TB services, involvement of medical colleges and their hospitals is paramount. The role of medical college professors in TB control as opinion leaders and role models for practising physician and as teachers imparting knowledge and skills and shaping the attitude of medical students cannot be underestimated. There is a pressing need for all medical schools to advocate DOTS and through this strategy provide the best opportunity for cure of patients. Priority activities to be undertaken by medical colleges are: (1) Training and teaching of RNTCP. (2) Service delivery of the RNTCP. (3) Advocacy of the RNTCP. (4) Operational research. A National Tast Force is being constituted comprising representatives from the zonal nodal centers, Central TB Institutes, and Central TB Division. With the establishment of zonal nodal centres and task forces at the different levels, it is envisaged that the movement will gain further momentum.
The bidirectional relationship between TB and nutrition is well recognized - primary undernutrition is a risk factor for developing TB disease, while TB results in wasting. Although nutrition support is acknowledged as an important intervention in TB programmes, it is seldom afforded commensurate priority for action. TB incidence and deaths worldwide are falling too slowly to meet WHO End TB Strategy milestones, and the number of undernourished people is increasing, likely to be further exacerbated by the ongoing COVID-19 pandemic. Undernutrition needs to be more urgently and intensively addressed. This is especially true for the WHO South-East Asia Region, where the high rates of undernutrition are a key driver of the TB epidemic. The evidence base has been sufficiently robust for clear and workable programmatic guidance to be formulated on assessment, counselling and interventions for TB patients. Many high-burden countries have developed policies addressing TB and nutrition. Gaps in research to date have frustrated the development of more refined programmatic approaches related to addressing TB and malnutrition. Future research can be shaped to inform targeted, actionable policies and programmes delivering dual benefits in terms of undernutrition and TB. There are clear opportunities for policy-makers to amplify efforts to end TB by addressing undernutrition.
Despite overwhelming evidence for the association between tuberculosis (TB) and tobacco use, it remains neglected in the context of policy, planning and practice. There is limited evidence about the extent of integration of TB and tobacco control programmes in South-East Asia Region (SEAR) countries.To assess the level of TB-tobacco integration in 11 SEAR countries.Cross-sectional study using a structured questionnaire addressed to TB and tobacco focal points at the World Health Organization Country Offices.Apart from India, no country in the SEAR has a formal coordination mechanism for national TB and tobacco control programmes or a system of referral for tobacco users among TB patients for treatment of tobacco dependence. There is no joint planning, joint training or joint supervision and monitoring in any country.There is poor integration between TB and tobacco control programmes in most SEAR countries. This assessment fed into the development of a regional framework for TB-tobacco integration, which outlines three strategies: 1) integrated patient-centred care and prevention; 2) joint TB tobacco actions covering policy development, planning, training and monitoring; and 3) research and innovation. Every country in the region should adopt the TB-tobacco integration framework to improve programme performance.
Background: Infertility is a very important issue to family and society. Oxidative stress (OS) may affect ovulation, fertilization, embryo development, and implantation resulting in infertility in women. Gonadotropins are required for follicle development and estrogen production, hence low levels of these hormones may result infertility.
Aim and Objectives: Our aim was to study OS and serum gonadotropins level in infertile women and to study whether the OS has any effect on gonadotropins level in infertile women.
Materials and Methods: It is a hospital-based cross-sectional study. The study group included 50 infertile women in the age of 2045 years. Age-matched 50 women without a history of infertility were selected as control. Serum samples were collected on the third day of the menstrual cycle and assayed for carbonylation of serum protein, a marker of OS by Levines method and Serum Follicle-stimulating hormone and luteinizing hormone by Chemiluminescence Immunoassay method in ADVIA, Centaur CP (SIEMENS) autoanalyzer. Statistical analysis of data was done by SPSS software. P < 0.05 was considered statistically significant.
Results: From our study, we observed that OS was significantly high in infertile women than control (P < 0.05). Serum gonadotropins levels were significantly low in infertile women than control (P < 0.05). Our study shows significant negative correlations between OS and serum gonadotropins level in infertile women (P < 0.001).
Conclusion: It can be concluded that both OS and low serum gonadotropin levels may be etiological factors for infertility in women. Oxidative can cause infertility by direct effect on reproduction physiology as well as by lowering gonadotropin level. So OS and serum gonadotropin levels can be emphasized in case of treatment of female infertility.
The COVID-19 pandemic challenged the Global Outbreak Alert and Response Network's (GOARN) mechanism used to rapidly deploy technical support for international responses and highlighted areas that require strengthened capacity within the Network. GOARN's partners in the World Health Organization's (WHO) South-East Asia and Western Pacific regions were engaged to explore their levels of preparedness, readiness and ability to respond to international public health emergencies.
In September 2018, all countries made a commitment at the first ever United Nations High‐Level Meeting (UNHLM) on TB, to provide TB preventive treatment (TPT) to at least 30 million people at high‐risk of TB disease between 2018 and 2022. In the WHO South‐East Asia Region (SEA Region), which accounts for 44% of the global TB burden, only 1.2 million high‐risk individuals (household contacts and people living with HIV) were provided TPT (11% of the 10.8 million regional UNHLM TPT target) in 2018 and 2019. By 2020, almost all 11 countries of the SEA Region had revised their policies on TPT target groups and criteria to assess TPT eligibility, and had adopted at least one shorter TPT regimen recommended in the latest WHO TPT guidelines. The major challenges for TPT scale‐up in the SEA Region are resource shortages, knowledge and service delivery/uptake gaps among providers and service recipients, and the lack of adequate quantities of rifapentine for use in shorter TPT regimens. There are several regional opportunities to address these gaps and countries of the SEA Region must make use of these opportunities to scale up TPT services rapidly to reduce the TB burden in the SEA Region.
This study assessed the prevalence and causes of unilateral visual impairment in the urban population of Hyderabad city as part of the Andhra Pradesh Eye Disease Study. Stratified, random, cluster, systematic sampling was used to select 2,954 subjects from 24 clusters representative of the population of Hyderabad. Eligible subjects underwent detailed eye examination including logMAR visual acuity, refraction, slitlamp biomicroscopy, applanation tonometry, gonioscopy, dilatation, cataract grading, and stereoscopic evaluation of fundus. Automated threshold visual fields and slitlamp and fundus photography were done when indicated by standardised criteria. Unilateral visual impairment was defined as presenting distance visual acuity < 6/18 in the worse eye and > or = 6/12 in the better eye, which was further divided into unilateral blindness (visual acuity < 6/60 in the worse eye) and unilateral moderate visual impairment (visual acuity < 6/18-6/60 in the worse eye). A total of 2,522 subjects (85.4% of eligible), including 1,399 > or = 30 years old, participated in the study. In addition to the 1% blindness and 7.2% moderate visual impairment (based on bilateral visual impairment criteria) reported earlier in this sample, 139 subjects had unilateral visual impairment, an age-gender-adjusted prevalence of 3.8% (95% confidence interval 2.7-4.9%). The major causes of this visual impairment 39.9% were refractive error (42.9%), cataract (14.4%), corneal disease (11.5%), and retinal disease (11.2%). Of this unilateral visual impairment was blindness. The major causes of unilateral blindness were corneal disease (23.2%), cataract (22.5%), retinal disease (18%), and optic atrophy (12.9%). On the other hand, the predominant cause of unilateral moderate visual impairment was refractive error (67%) followed by cataract (9%). Of the total unilateral visual impairment, 34.3% was present in those < 30 years old and 36.2% in those 30-49 years old. Unilateral visual impairment afflicts approximately 1 in 25 persons in this urban population. A large proportion of this unilateral visual impairment is present in younger age groups. The causes of unilateral visual impairment, like those of bilateral visual impairment in this population, are varied, suggesting therefore, that in addition to the current focus of eye care in India predominantly on cataract, other causes of visual impairment need to be addressed as well.