Despite the rapid accumulation of advanced information governing iron nutrition, the diversity of dietary practices and economic circumstances have resulted in iron deficiency in developing as well as in affluent countries.

Iron Deficiency in Infancy and Childhood

WITH AN ESTIMATED ANNUAL incidence of 2.0–2.3 million tuberculosis (TB) cases and about 150 000–350 000 deaths per year, India has the highest TB burden in the world.1 TB control depends on early diagnosis of pulmonary TB cases and their treatment with a full course of anti-tuberculosis drugs.2 For early diagnosis of TB, all persons with cough of ⩾2 weeks should be referred for TB evaluation.3 Correct treatment requires the use of standardised drug regimens recommended by the World Health Organization (WHO),2 the International Standards for TB Care (ISTC) and the Standards for TB Care in India (STCI).2–4

A recent systematic review showed that in India there is a delay of nearly 2 months in making a diagnosis of TB; patients are seen by on average three different providers before a diagnosis is made.5 Drug prescription analyses have shown that irrational and inappropriate anti-tuberculosis drug regimens are widely used.6 These studies suggest that the quality of TB care in India is a matter of concern.7

The Indian health care delivery landscape is complex and fragmented, with many types of care providers in the public and private sectors.8 Studies suggest that 80% of the first-contact health care and nearly 50% of TB care occurs in the private sector.9 The private sector is also very fragmented, with both unqualified (i.e., no formal medical degree) and qualified providers (a formal degree in either allopathic medicine or in alternative traditions such as Ayurveda, Unani, Siddha and Homeopathy [AYUSH]).10,11 A recent study of 100 villages in rural Madhya Pradesh found that, among primary care providers identifying themselves as ‘doctors’, 65% reported having no formal medical training, while 25% had AYUSH degrees, and only 10% reported having an MBBS (Bachelor of Medicine, Bachelor of Surgery, i.e., formal allopathic medicine) degree. The quality of medical care was highly variable, and was found to be deficient on many levels.12,13

While several studies in India have investigated different aspects of health care providers’ knowledge and practices related to TB diagnosis and treatment, this literature has not been systematically reviewed or benchmarked against international standards.

http://www.letstalktb.org/wp-content/uploads/2015/11/Satyanarayana-IJTLD-2015.pdf

Quality of tuberculosis care in India: a systematic review

Pneumonia remains a major cause of child death globally, and improving antibiotic treatment rates is a key control strategy. Progress in improving the global coverage of antibiotic treatment is monitored through large household surveys such as the Demographic and Health Surveys (DHS) and the Multiple Indicator Cluster Surveys (MICS), which estimate antibiotic treatment rates of pneumonia based on two-week recall of pneumonia by caregivers. However, these survey tools identify children with reported symptoms of pneumonia, and because the prevalence of pneumonia over a two-week period in community settings is low, the majority of these children do not have true pneumonia and so do not provide an accurate denominator of pneumonia cases for monitoring antibiotic treatment rates. In this review, we show that the performance of survey tools could be improved by increasing the survey recall period or by improving either overall discriminative power or specificity. However, even at a test specificity of 95% (and a test sensitivity of 80%), the proportion of children with reported symptoms of pneumonia who truly have pneumonia is only 22% (the positive predictive value of the survey tool). Thus, although DHS and MICS survey data on rates of care seeking for children with reported symptoms of pneumonia and other childhood illnesses remain valid and important, DHS and MICS data are not able to give valid estimates of antibiotic treatment rates in children with pneumonia.

/pdf/measuring-coverage-in-mnch-challenges-in-monitoring-the-53mfl0cqu4.pdf

Measuring coverage in MNCH: challenges in monitoring the proportion of young children with pneumonia who receive antibiotic treatment.

The aim of this study is to explore health care providers' experiences and perceptions of their encounters with male and female patients in a rural district in India with special reference to tuberculosis (TB) care. The authors conducted semistructured interviews with 22 health care providers, 17 men and 5 women, from the public and private health care sectors. Findings reveal that doctors adopted an authoritarian as well as a consumerist approach in the medical encounter, indicating that power imbalances in the doctor-patient relationship are negotiable and subject to change. Gender was identified as an influencing factor of the doctor's dominance. A patient-centered approach, acknowledging patients' own experiences and shared decision making, is called for and should be included in TB control activities. This seems to be especially important for female patients, whose voices were not heard in the medical encounter.

Power Imbalance and Consumerism in the Doctor-Patient Relationship: Health Care Providers’ Experiences of Patient Encounters in a Rural District in India:

Information hiding scheme for digital images using difference expansion and modulus function

Color Image Steganography based on Pixel Value Modification Method Using Modulus Function

We analyze the decision problem of a workplace manager determining the optimal number of electric vehicle (EV) charging stations to install in order to supply employees with adequate charging service and take advantage of EV smart charging opportunities, while also considering the investment costs of installing additional infrastructure. To optimize smart charging revenues, we introduce assignment methods that designate specific charging spots to arriving EVs. This includes two heuristic packing methods and an offline oracle. Under each assignment method, we perform a cost-benefit analysis that determines the optimal number of chargers to install on-site. Our results highlight the importance of considering revenues from demand charge reduction to incentivize investment in additional infrastructure needed to tap into the smart charging potential of EVs, at least under current energy market prices.

Optimal Planning of Workplace Electric Vehicle Charging Infrastructure with Smart Charging Opportunities

Steganography is the art of hiding the very presence of communication by embedding secret messages into innocuous looking cover images. The Least Significant Bit (LSB) steganography that replaces the least significant bits of the host medium is a widely used technique with low computational complexity and high insertion capacity. Although it has good perceptual transparency, it is vulnerable to steganalysis which is based on histogram analysis. In all the existing schemes detection of a secret message in a cover image can be easily detected from the histogram analysis and statistical analysis. Therefore developing new LSB steganography algorithms against statistical and histogram analysis is the prime requirement.

A modulo based LSB steganography method

CONTEXTE : Le systeme de medecine indienne est tres populaire en Inde. OBJECTIF : Apprecier les connaissances et le type de pratique des praticiens medicaux indigenes (IMPs) non-allopathes en ce qui concerne la tuberculose (TB). METHODES: Nous avons interviewe 74 IMPs pratiquant dans le bloc de Naraingarh, une zone rurale de l'Etat de Haryana en Inde, grâce a un schema d'interview semi-structure. RESULTATS: Quarante des 74 IMPs (54%) voient de deux a cinq patients tuberculeux chaque mois. Quarante-six sur 74 (61%) signalent qu'ils diagnostiquent la TB sur base des seuls symptomes, alors que 38% utilisent des tests de diagnostic comme les cliches du thorax, la vitesse de sedimentation globulaire et l'examen des expectorations. Quarante pour cent des IMPs considerent que l'alcool est la cause de la TB, 36,5% impliquant le tabagisme et 17,6% l'infection. Trente-quatre pour cent seulement (25/ 74) des IMPs signalent qu'ils traitent les patients TB alors que les autres affirment qu'ils referent de tels cas aux hopitaux proches. Les medicaments antituberculeux utilises par les IMPs sont l'isoniazide, la rifampicine et la streptomycine, mais aucun d'entre eux ne connait le dosage de ces medicaments, la duree de traitement ou le regime correct. Soixante-quatre pour cent de 25 IMPs font etat de l'utilisation de medicaments ayurvedic. CONCLUSION : Une proportion considerable des patients TB consultent les IMPs pour le traitement de la TB alors que les connaissances et la pratique de ces derniers sont inadequates.

V. Nagaraj

Papers

Color Image Steganography based on Pixel Value Modification Method Using Modulus Function

Optimal Planning of Workplace Electric Vehicle Charging Infrastructure with Smart Charging Opportunities

A modulo based LSB steganography method

Knowledge and practice pattern of non-allopathic indigenous medical practitioners regarding tuberculosis in a rural area of India.

Speech emotion recognition based on machine learning tactics and algorithms