Clinical profile of anterior uveitis in tertiary health centre of central India

To study the clinical profile of anterior uveitis in patients attending the Ophthalmology department of tertiary health centre of central India A cross-sectional, observational study was done in the department of Ophthalmology of tertiary health centre from January 2017 to July 2019. A total of 199 cases of anterior uveitis were studied to assess their clinical presentation and etiology. After thorough history taking, demographic data and clinical pattern were documented. Comprehensive ophthalmic evaluation, necessary laboratory investigations and radiological imaging were performed to establish the etiology. The maximum number (n=79; 39.7%) of patients were in the age group of 21-40 years and the mean age of the study subjects was 36.9+21.8 years. The male to female ratio was 1:1.42 (117 females, 82 males). Uniocular disease was found in 91.95% cases and majority (n=175; 87.93%) of the patients had acute presentation with 95.47% cases having non granulomatous uveitis. A specific diagnosis could not be made in 62.8% cases. Trauma (21.7%) was the most common cause in patients with a specific diagnosis. Persistent posterior synechiae was the most frequently seen complication (21.08%) although majority of the patients (66.8%) did not reveal any major complications.Patients with anterior uveitis most commonly had acute presentation. The disease was rarely bilateral and was mostly non-granulomatous in presentation. It was mostly idiopathic and among the known etiological factors, trauma was the most common cause.

Evaluation of decadal land degradation dynamics in old coal-mines of Central India

The present study attempts to understand land use dynamics in an area subjected to opencast and underground coal mining for the last few decades in Kotma Coalmines of Anuppur district in Madhya Pradesh, India through geospatial techniques. Land Use and Land Cover (LULC) change detection analysis was performed digitally classifying Landsat 5 (2001) as well as Landsat 8 (2020) satellite data using maximum likelihood algorithm. Results revealed that area under Dense native vegetation decreased drastically (13.74 sq. km) with the gradual and consistent expansion in the activities of coal mines which showed the highest increase in area over time (15.84 sq. km). Bivariate regression analysis showed the positive empirical relationships between vegetation indices and soil physico-chemical parameters. Studies suggested soil and vegetation is degraded over the large mining areas consistently over a long time period. Despite the continuous reforestation activities on mined areas, the decline area under dense vegetation and sparse vegetation over the twenty-year time-scale indicates that the reclamation activities are still in its’ infancy. Land Degradation Vulnerability Index (LDVI) map was generated to understand the extent of decadal land degradation trends and it shows that 8.60 % of the area is highly vulnerable to degradation. The LDI inputs will help the planners to develop alternate strategies to tackle vulnerability zones for safe mining. Monthly estimation of various meteorological parameters was also recorded to generate heat plots for the period 2001-2020. The study concludes that monitoring and assessment of fragile ecosystems are indispensable for holistic environmental management.

Study of Seroprevalence of SARS CoV2 antibodies in children in a diagnostic centre of Central India-a retrospective study

It is said that children are less affected by SARSCoV2 infection because of their young immune system, so they have relatively milder symptoms as compared to adults. So the true incidence of SARSCoV2 is not known in this age group. Serosurveys in the paediatric age group can give a much better estimate of the incidence of SARSCoV2 infection in asymptomatic and symptomatic childrenThe present study was undertaken to study the seroprevalence of SARSCoV2 antibodies in children below 18 years of age, by measuring the S1RBD domain of spike protein neutralizing IgG antibody levels.This was a retrospective study carried out from August 2020 to August 2021 in a private diagnostic centre of Central India. 539 children of both genders from newborn babies upto 18 years of age were included in the study. US FDA Emergency Use Authorized [EUA], Atellica Solution SARS-CoV-2 IgG assay that detects anti S1-RBD antibodies including neutralizing IgG against SARS-CoV-2 was used for antibody estimation. Antibody level ≥1 was termed reactive or seropositive and below 1 were considered to be non reactive or seroneagtive There were 321 males and 218 females with a male to female ratio of 1.47 :1. 57% male children were seropositive while 61.9% female children showed seropositivity with an overall positivity rate of 58.99%.The findings of our study suggest that chidren below 5 years and adolescents exhibit higher antibody responses as compared to children between 5-10 years of age. The results of our study would be of help in formulating surveillance and vaccination strategies for children and in implementing public safety guidelines.

Summer monsoon low pressure systems over the Indian region and their relationship with the sub-divisional rainfall

In the present paper performance of the monthly sub-divisional summer monsoon rainfall is studied in association with the position of the Low Pressure System (LPS) over the Indian region. Existence of the LPS over a particular location increases the rainfall activities in certain parts of the country while decreases in some other parts. For this study, the Indian region (5°-35° N and 60° -100° E) is divided into 5° Lat. ´ 5° Long. grids. The duration of LPS is taken in terms of LPS days with respect to the location of LPS in a particular grid. Monthly total number of LPS days in each of the grids are computed during the summer monsoon season, June to September for the period 1891 – 1990. Maximum number of LPS days (more than half of the total) are observed in the latitude belt between 20°-25°N. The percentages of total LPS days in this area are higher in July and August which are peak monsoon months as compared to June and September. When there is a LPS are in the area 20°-25° N and 80°-90° E, there is significant increase in the rainfall activities in the sub-divisions along mean monsoon trough while northeast India and southeast peninsular India experience significant decrease in rainfall in the months of July and August. Owing to the movement of LPS from east to west through central India, most parts of the country, excluding northeast India and south peninsular India get good rainfall activity. Correlation coefficients between monthly LPS days over the different grids and monthly sub-divisional rainfall are computed to study the relationships. The performance of sub-divisional rainfall mostly related with the occurrence of LPS in certain grid- locations. The correlation field maps may give some useful information about rainfall performance due to LPS in a particular grid locations.

Possible mechanisms related to internal dynamics for anomalously high rainfall during August 2020 of Indian Summer Monsoon

In the present study, an investigation is made to understand the physical mechanism behind the anomalous high rainfall during August 2020 over the Indian subcontinent using both observation and GFS T1534 weather forecast model. According to India Meteorological Department (IMD), the country receives 27% excess rainfall in the month of August 2020. The excess rainfall is mainly contributed by the 5 well marked low pressure systems which formed over Bay of Bengal and moved west-northwestwards across central India up to Western Madhya Pradesh and Rajasthan. The analysis reveals that the observed anomalous rainfall is distributed over central India region extending from coastal Orissa to central part of Chhattisgarh, Madhya Pradesh and western coast of Gujarat region. It is also found that the August-2020 heavy rainfall is mainly contributed by the synoptic (2-10 days) component of the total rainfall whereas the contribution of the large-scale intraseasonal oscillation (ISO) component (10-90 days) is quite less. Although the present operational Global Forecast System (GFS) T1534 (GFS T1534) is able to predict the anomalous high rainfall with day-1 lead time, it underestimates the magnitude of the synoptic variance. Further, the large-scale dynamical and thermodynamical parameters show anomalous behaviour in terms of strong low level (850 hPa) jet, vertical velocity and associated moisture convergence in the lower level. The GFS T1534 is able to forecast the above large-scale features reasonably well even with day-5 lead time. From energetics analysis, it is found that the mean kinetic energy (MKE) is stronger for August 2020 as compared to climatological value and the strong MKE efficiently transfers the energy to the synoptic scale, and hence the synoptic eddy kinetic energy is higher. Along with that, the ISO scale kinetic energy for August 2020 is less compared to the August climatological value. GFS T1534 model has some fidelity in capturing the energy conversion processes, but it has some difficulty in capturing the magnitude with increased lead time.

An exploration of attributes effecting the relationship between competencies and performance of CHWs in a rural block.

Introduction: Induction of Community Health Workers (CHWs) into various health programs is considered as an integral strategy to achieve universal health coverage. Thus, it is prudent to explore and understand the CHWs individual and the system level interactions and their further translation into performance and actionable domains. Objective: To quantify the relationship structure between envisioned competencies and CHW performance with factors operating at individual and the immediate system level as effect modifiers. Methodology: A cross-sectional study was done in primary rural health care settings of Madhya Pradesh state in Central India. CHWs were stratified as relatively low performing (RLP) and relatively high performing (RHP) based on their annual performance-based incentives for the year (April 2017- March 2018). CHWs were administered a self-reported questionnaire that included socio demographic details, knowledge, skills assessment and availability of logistics. Results: Among the 90 eligible CHWs, 31 RLP and 30 RHP CHWs were interviewed. The CHWs performance was found to be significantly associated with age, education, caste, presence of under 5 children, knowledge and competency scores. However, while adjusting for the confounders only age and educational status were found to be significant. Further cluster analysis revealed two clusters based on individual and system characteristics which was found to influence the CHWs performance. Conclusion: The relationship between the CHWs truest competencies and performance based incentivisation tends to have been influenced by age and education which could help in developing a more focused supportive supervision catering to their needs. Keywords: community health worker, performance, health system, competency.

Development of tool for assessment of performance motivation and job satisfaction among the Community Health Workers of Central India.

Introduction: Among the various factors influencing the performance of Community health workers, motivation and job satisfaction serves as a potential drive to perform better. Hence, this study aimed at constructing a motivation and job satisfaction tool in a systematic method that would serve as a potential tool for further research considering the heterogeneity in the study population. Objective: To develop a tool to measure how well the CHWs are motivated and satisfied pertaining to individual, community and health system determinants. Methods: This cross-sectional study from rural block of Madhya Pradesh in Central India included relatively high performing and low performing CHWs based on their annual performance-based incentives for the year (April 2017- March 2018). The CHWs were administered a self-reported questionnaire that contained a 5-point Likert scale with individual, health system and community determinants of motivation and job satisfaction. Results: The performance motivation scale with 18 items and job satisfaction scale with 15 items were administered to the 92 CHWs. Their item content validity index was 0.66 and 0.83 respectively. The finalized tool consisted of 11 items in motivation scale and all the 15 items in job satisfaction scale following the Explanatory factor analysis. All the individual constructs in both the scales showed good internal consistency with Cronbachs alpha ranging from 0.62-0.88. The overall median (IQR) score of both RLP and RHP CHWs were 4(4-5) in both the questionnaires. Conclusion: The CHWs in our study were intrinsically motivated and were satisfied with their performance as voluntary village health workers. Further research would be planned to validate the constructs using confirmatory factor analysis. Keywords: Community Health workers, Motivation, Job satisfaction, Content validity