Suchergebnisse

This paper reflects on the dichotomy of state and culture through 'certain groups of people', impacting their behaviour and wants towards their own health. Analysis commences with a brief commentary on pre-independence India, whereby the rhetoric of nationalism was imprinted on individual bodies through the call for maintaining the health of a nation. This argument is then extended to include the present day-scenario of the state, whereby, the state sees itself as something beyond the individual; where it is the hub of 'know-how' of maintaining its population, yet at the same time distant from it. Second section presents the control of culture through community on the bodies of individual members (women). The two arguments are based on the review of an in-depth study by Jeffery and Jeffery (2010) in a village in Uttar Pradesh on the perceptions of the village population on national health policies. The article is concluded, with the necessity to understand and discover discourses of not state vs. culture (or community), but also of state and culture vs. agency vis-à-vis health and health care provisions.K

The major histocompatibility complex (MHC) harbours genes that have a primary function of regulating immune responsiveness. Our data on the distribution patterns of molecular subtypes of HLA class I and II extended haplotypes in India suggest that: (1) Asian Indians have extreme diversity in the MHC region, with several novel and unique alleles and disease-associated MHC haplotypes (e.g. the autoimmune-favouring A26-B8-DR3 haplotype); (2) there have been selective environmental and microbial pressures in India that directed either the generation of novel alleles through founder effect or the expansion of other alleles due to geophysical or socio-economic barriers, and (3) Asian Indians have a unique repertoire of peptide-presenting molecules to deal with pathogen-derived autoreactive antigens. This level of polymorphism concentrated within the MHC presents a formidable obstacle to the development of peptide-based vaccines, e.g. for AIDS. Further, studies conducted by us and others have provided a genetic basis for the possible predisposition and fast progression of HIV infections in the Indian population. Since there is selective predominance of different HLA alleles and haplotypes in different populations, a dedicated global screening effort is required to develop MHC-based vaccines against infectious diseases.

The present study was conducted to find out the changes in anthropometric measurements with advancing age among elderly males living in old-age homes and those living in family. Cross-sectional data on anthropometric measurements and other general information were obtained for 400 male subjects (200 living in old-age homes and 200 living with family) ageing 60 years and above, and data were collected from various districts in Punjab. Height decreased non-significantly and sitting height decreased significantly ( p = 0.03) from 60 years to ≥80 years of age in both the groups of elderly males. Weight decreased significantly among the elderly males residing in old-age homes ( p < 0.001). Biceps ( p = 0.03) and thigh skinfold ( p = 0.009) thicknesses decreased significantly only among elderly residing in old-age homes. Abdominal ( p = 0.01) and supra-iliac ( p = 0.01) skinfold thickness measurements decreased significantly among elderly residing with their families. Circumference measurements on limbs decreased significantly ( p < 0.01) among both the groups of elderly (except upper arm circumference among elderly residing with their families). Abdominal circumference decreased significantly ( p = 0.04) among the elderly males residing with their families. Elderly residing in old-age homes retained more abdominal subcutaneous fat mass and lost more appendicular fat mass as compared with those residing with their families. Elderly residing with their families lost lesser appendicular muscle mass as compared with their counterpart's elderly residing in old-age homes.

Introduction Nearly 220 thousand patients are diagnosed with End Stage Renal Disease (ESRD) 33 every year, which calls for an additional demand for 34 million dialysis sessions in India. The Government of India has announced a National Dialysis Program to provide for free dialysis in public hospitals. In this paper, we estimate the overall cost of performing hemodialysis (HD) in a tertiary care hospital. Secondly, we also assess the catastrophic impact of out of pocket expenditure for hemodialysis on households and its determinants. Methods Economic health system cost of HD was estimated using bottom-up costing methods. All resources, capital and recurrent, utilized for service delivery from April 2015 to March 2016 were identified, measured and valued. Capital costs were annualized after accounting for their useful life and discounting at 3% for future years. Sensitivity analyses were undertaken to determine the effect of variation in the input prices, and other assumptions on the annual health system cost. Out of pocket expenditure (OOPE) was assessed by interviewing 108 patients undergoing HD in the study hospital to account for cost from the patient's perspective. The prevalence of catastrophic health expenditure (CHE) was computed as per threshold of 40% of non-food expenditure. Results The overall average cost incurred by the health system per HD session was INR 4,148 (USD 64). Adjusting for capacity utilization, health system incurred INR 3,025 (USD 47) per hemodialysis at 100% bed-occupancy. The mean out of pocket expenditure per patient per session was INR 2,838 (USD 44;95% CI: USD 34-55). Major component of this OOPE was on medicines and consumables (64.1%). The prevalence of catastrophic health expenditure per HD session was 11.1%. Conclusion Our study findings would be useful in context of planning for dialysis services, set provider payment rates for dialysis under various publicly sponsored health insurance schemes, and undertake future cost-effectiveness analysis to guide resource allocation ...