Municipal Corporation Of Greater Mumbai Research Articles

Physiotherapy Management of a Middle-Aged Adult Male with Severe Symptoms of Coronavirus Disease-19: A Case Report

Coronavirus disease-19 (COVID-19) has affected people of various age groups with symptoms ranging from asymptomatic or mild to severe respiratory failure, with mild symptoms requiring little or no medical intervention whereas severe symptoms requiring hospitalisation and prompt medical management. The following case report illustrates about recovery of a patient with severe symptoms of COVID-19 in a COVID dedicated tertiary care hospital run by the Municipal Corporation of Greater Mumbai. Physiotherapy has long been a part of multidisciplinary team in management of patients with severe respiratory illnesses. The report mainly presents about the Physiotherapy management undertaken for the above-mentioned patient parallelly to the Medical management aiding in recovery of the patient.

Tocilizumab improves survival in patients with persistent hypoxia in severe COVID-19 pneumonia.

Kewan et al. [[1]Kewan T. Covut F. Al-Jaghbeer M.J. Rose L. Gopalakrishna K.V. Akbik B Tocilizumab for treatment of patients with severe COVID-19: a retrospective cohort study.EClin Med. 2020; 24100418Google Scholar] have shown that using single dose 400 mg tocilizumab reduces the duration of critical resource use in severe Coronavirus disease 2019 (COVID-19) pneumonia. They had included patients with hypoxia, lung infiltrates and elevated inflammatory markers. We work at a government-funded tertiary care center in India. We had compassionate use access to tocilizumab from 13th May 2020. In view of resource-limitation, we decided to use it in patients with severe COVID-19 pneumonia with lung infiltrates, elevated inflammatory markers and persistent hypoxia (oxygen saturation of 94% or less despite giving supplemental oxygen of 15 L/min via non-rebreathing mask or PaO2/FiO2 ratio of less than 200). We present data from a retrospective cohort study performed at our center over a 6 week period from 20th April 2020 to 5th June 2020. A total of 1370 patients with COVID-19 were admitted in the department of medicine during this period. Of these, 985 (72%) had hypoxia, defined as oxygen saturation 94% or less, at presentation. Of these, 210 patients met the inclusion criteria of oxygen saturation of 94% or less despite giving supplemental oxygen of 15 L/min via non-rebreathing mask or PaO2/FiO2 ratio of less than 200. Of these, 49 patients died within 24 h of admission and were excluded from the analysis. The remaining 161 patients were considered for analysis. Of the 161 patients, 70 received a single intravenous dose of 400 mg tocilizumab while 91 did not. All patients received antibiotics, hydroxychloroquine 400 mg once daily, ivermectin 12 mg once daily, oseltamivir 75 mg twice daily, low molecular weight heparin 1 mg/kg subcutaneously once daily (twice daily if d-dimer >3000 ng/mL), methylprednisolone 125–500 mg intravenously once daily, and other supportive care as needed. Tocilizumab group had younger patients than control group (median 52 years versus 55 years; p value 0·001) (Table 1). Eight (8·8%) patients in the control group while 2 (2·9%) patients in the tocilizumab group received invasive ventilation (p value 0·122). One (1·1%) patient in the control group and 17 (24·3%) patients in the tocilizumab group received non-invasive ventilation (p value 0·001). The median days of hospitalization were 11 (interquartile range (IQR): 4·5 to 21). The median days of follow up was 16 (IQR: 4·5 to 50). At last follow up, 94 (58·4%) patients died, 56 (34·8%) have been discharged from the hospital and 11 (6·8%) are still admitted. On multivariable Cox regression analysis with age, hypertension, tocilizumab use, use of invasive ventilation and use of non-invasive ventilation, the independent predictors of death were age (Hazards ratio (HR) 1·022; 95% CI: 1·001 to 1·044) and tocilizumab use (HR 0·616; 95% CI: 0·382 to 0·992).Table 1Comparison between patients who received tocilizumab versus those who did not. The data are expressed as either median (interquartile range) or number (percentage). Category E was defined as pneumonia with respiratory failure while Category F was defined as pneumonia with respiratory failure and multi-organ dysfunction [[2]Revised guidelines on clinical management of COVID-19. Ministry of health & family welfare, directorate general of health services, government of India, (2020). https://www.mohfw.gov.in/pdf/RevisedNationalClinicalManagementGuidelineforCOVID1931032020.pdf, last accessed on 21st June 2020.Google Scholar]. Chi-square test was used for categorical data while Mann Whitney U test was used for continuous data.Tocilizumab groupControl groupP valueNumber of patients7091Age52 (44–57)55 (48–65)0·001Male Sex47 (67·1)53 (58·2)0·248Diabetes33 (47·1)49 (53·8)0·399Hypertension16 (22·9)39 (42·9)0·008Any comorbidity43 (61·4)68 (74·7)0·071CRP115·5 (56–178·7)97 (88–104)0·314Respiratory Rate34(30–38)31(25–40)0·281Category0·753E62 (88·6)82 (90·1)F8 (11·4)9 (9·9)Noninvasive ventilation17 (24·3)1 (1·1)0·001Invasive ventilation2 (2·9)8 (8·8)0·122Days of hospitalization14 (9–25·5)6(3–14)0·001Days of follow up31 (11·75–48)7(3–50)0·072Discharged patients26 (37·1)30 (33)Ongoing hospitalization11 (15·7)0 (0)Deaths33 (47·1)61 (67)0·011 Open table in a new tab Thus, we conclude that tocilizumab use is associated with survival benefit in patients with persistent hypoxia in severe COVID-19 pneumonia. Dr Gokhale has nothing to disclose. Dr Mehta has nothing to disclose. Dr Karnik has nothing to disclose. Dr Kulkarni has nothing to disclose. Mr Gokhale has nothing to disclose. Tocilizumab was made available by the Municipal Corporation of Greater Mumbai, Money-Life Foundation, and Madat Charitable Trust. The raw data will accessible on contacting the corresponding author.

Diagnostic Accuracy of Community-Based Diabetic Retinopathy Screening With an Offline Artificial Intelligence System on a Smartphone

Offline automated analysis of retinal images on a smartphone may be a cost-effective and scalable method of screening for diabetic retinopathy; however, to our knowledge, assessment of such an artificial intelligence (AI) system is lacking. To evaluate the performance of Medios AI (Remidio), a proprietary, offline, smartphone-based, automated system of analysis of retinal images, to detect referable diabetic retinopathy (RDR) in images taken by a minimally trained health care worker with Remidio Non-Mydriatic Fundus on Phone, a smartphone-based, nonmydriatic retinal camera. Referable diabetic retinopathy is defined as any retinopathy more severe than mild diabetic retinopathy, with or without diabetic macular edema. This prospective, cross-sectional, population-based study took place from August 2018 to September 2018. Patients with diabetes mellitus who visited various dispensaries administered by the Municipal Corporation of Greater Mumbai in Mumbai, India, on a particular day were included. Three fields of the fundus (the posterior pole, nasal, and temporal fields) were photographed. The images were analyzed by an ophthalmologist and the AI system. To evaluate the sensitivity and specificity of the offline automated analysis system in detecting referable diabetic retinopathy on images taken on the smartphone-based, nonmydriatic retinal imaging system by a health worker. Of 255 patients seen in the dispensaries, 231 patients (90.6%) consented to diabetic retinopathy screening. The major reasons for not participating were unwillingness to wait for screening and the blurring of vision that would occur after dilation. Images from 18 patients were deemed ungradable by the ophthalmologist and hence were excluded. In the remaining participants (110 female patients [51.6%] and 103 male patients [48.4%]; mean [SD] age, 53.1 [10.3] years), the sensitivity and specificity of the offline AI system in diagnosing referable diabetic retinopathy were 100.0% (95% CI, 78.2%-100.0%) and 88.4% (95% CI, 83.2%-92.5%), respectively, and in diagnosing any diabetic retinopathy were 85.2% (95% CI, 66.3%-95.8%) and 92.0% (95% CI, 97.1%-95.4%), respectively, compared with ophthalmologist grading using the same images. These pilot study results show promise in the use of an offline AI system in community screening for referable diabetic retinopathy with a smartphone-based fundus camera. The use of AI would enable screening for referable diabetic retinopathy in remote areas where services of an ophthalmologist are unavailable. This study was done on patients with diabetes who were visiting a dispensary that provides curative services to the population at the primary level. A study with a larger sample size may be needed to extend the results to general population screening, however.

Effectiveness of NGO-government partnership to prevent and treat child wasting in urban India.

This study reviews the performance of a community-based nutrition programme in preventing and treating wasting without complications among children under age three in urban informal settlements of India. Implemented by a non-profit organization, with national (Integrated Child Development Services [ICDS]) and city-level (Municipal Corporation of Greater Mumbai [MCGM]) government partners, the programme screened 7,759 children between May 2014 and April 2015. During this period, the programme admitted 705 moderately wasted and 189 severely wasted children into the treatment group and 6,820 not wasted children into the prevention group. Both prevention and treatment groups received growth monitoring, referrals to public health facilities, and home-based counselling (if <6months) by community health workers. Treatment groups received additional home-based counselling and access to medical screenings. Severely wasted children also received access to ready-to-use therapeutic food. The study assessed default rates, wasting status, and average weight gain 3months after admission. Factors associated with growth faltering in the prevention group were explored using logistic regression. Default rates for the severely wasted, moderately wasted, and prevention group were 12.7%, 20.4%, and 22.1%, respectively. Recovery rate was 42.4% for the severely wasted and 61.3% for the moderately wasted. For the moderately wasted, mean weight gain was 2.1g/kg/day, 95% confidence interval (CI) [1.6, 2.6], and 4.5g/kg/day for the severely wasted, 95% CI [3.1, 5.9]. Among prevention group children, 3.6% faltered into wasting-3.2% into moderate and 0.4% into severe. The paper gives insights into ways in which ICDS and MCGM can successfully integrate large-scale community-based acute malnutrition programming.

Innovation in governance through academic participation: urban governance

Stakeholder involvement through public participation forms the backbone of a good policy model and students need to be a part of this process. Our paper aims at charting out a live project that Observer Research Foundation (ORF) Mumbai, a think-tank and Municipal Corporation of Greater Mumbai's (MCGM) Revised Draft Development Plan (RDDP) team undertook with respect to student participation in the development plan (DP) of Mumbai. ORF approached the MCGM with a plan to opening doors to students and mobilised urban planning and architecture colleges. Over 250 students from 20 institutes attended an academic interaction with the DP chief followed by a paper writing competition on ideas for the DP. This experiment makes a case for mainstreaming the inclusion students in policy formation. Such processes not only stimulate young minds and educators, but it keeps them in touch with the real-world and develops a sense of belonging to government processes.

Innovation in governance through academic participation: urban governance

Stakeholder involvement through public participation forms the backbone of a good policy model and students need to be a part of this process. Our paper aims at charting out a live project that Observer Research Foundation (ORF) Mumbai, a think-tank and Municipal Corporation of Greater Mumbai's (MCGM) Revised Draft Development Plan (RDDP) team undertook with respect to student participation in the development plan (DP) of Mumbai. ORF approached the MCGM with a plan to opening doors to students and mobilised urban planning and architecture colleges. Over 250 students from 20 institutes attended an academic interaction with the DP chief followed by a paper writing competition on ideas for the DP. This experiment makes a case for mainstreaming the inclusion students in policy formation. Such processes not only stimulate young minds and educators, but it keeps them in touch with the real-world and develops a sense of belonging to government processes.

Spatio-temporal analysis of sub-hourly rainfall over Mumbai, India: Is statistical forecasting futile?

Mumbai, the commercial and financial capital of India, experiences incessant annual rain episodes, mainly attributable to erratic rainfall pattern during monsoons and urban heat-island effect due to escalating urbanization, leading to increasing vulnerability to frequent flooding. After the infamous episode of 2005 Mumbai torrential rains when only two rain gauging stations existed, the governing civic body, the Municipal Corporation of Greater Mumbai (MCGM) came forward with an initiative to install 26 automatic weather stations (AWS) in June 2006 (MCGM 2007), which later increased to 60 AWS. A comprehensive statistical analysis to understand the spatio-temporal pattern of rainfall over Mumbai or any other coastal city in India has never been attempted earlier. In the current study, a thorough analysis of available rainfall data for 2006–2014 from these stations was performed; the 2013–2014 sub-hourly data from 26 AWS was found useful for further analyses due to their consistency and continuity. Correlogram cloud indicated no pattern of significant correlation when we considered the closest to the farthest gauging station from the base station; this impression was also supported by the semivariogram plots. Gini index values, a statistical measure of temporal non-uniformity, were found above 0.8 in visible majority showing an increasing trend in most gauging stations; this sufficiently led us to conclude that inconsistency in daily rainfall was gradually increasing with progress in monsoon. Interestingly, night rainfall was lesser compared to daytime rainfall. The pattern-less high spatio-temporal variation observed in Mumbai rainfall data signifies the futility of independently applying advanced statistical techniques, and thus calls for simultaneous inclusion of physics-centred models such as different meso-scale numerical weather prediction systems, particularly the Weather Research and Forecasting (WRF) model.

Improving Sanitation in the Slums of Mumbai: An Analysis of Human Rights-Based Approaches for NGOs

Human rights-based approaches (HRBAs) can challenge the underlying structures and power relations that perpetuate poverty. They have thus emerged in the development field as a prominent instrument for addressing development issues. Access to clean water and sanitation are now internationally acknowledged as human rights, and have become a stand-alone Sustainable Development Goal of the international community’s commitment to international development. This paper analyses the potential use of HRBAs by local Non-Governmental Organisations (NGOs) working on sanitation issues in slums in Mumbai. It is argued that it is more productive for local NGOs to build (i) partnerships with duty-bearers (in this case the state and the Municipal Corporation of Greater Mumbai) and (ii) the capacity of rights-holders, in particular women, than to rely on litigation strategies to create momentum for change. HRBAs are more useful as a political tool for NGOs for establishing good working relationships with government agencies rather than as a legal instrument, which can be counter-productive to the poverty reduction objectives of NGOs.

Assessing the exposure of street sweeping and potential risk factors for developing musculoskeletal disorders and related disabilities: a cross-sectional study

ObjectiveThis study aims to assess the exposure of those involved in street sweeping to the development of musculoskeletal disorders (MSDs) and related disabilities and tries to identify the individual risk...

Migration, Diversification of Livelihood Sustainability: A Case of Mankhurd, Mumbai

The present paper is an empirical one based on certain pockets of Mumbai which could be called as a peripheral boundary of new Mumbai and old Mumbai, Mankhurd, is the focus of the study. Mankhurd an eastern suburb of Mumbai city comes under M ward (zone-5 as Mumbai has been divided into 6 zones. Mumbai is a complete urban area and divided into two administrative areas known as Mumbai and suburban Mumbai district from 2001 and its political, economic life is governed by one civic body – Municipal Corporation of Greater Mumbai, to work for welfare of its population in terms of providing all basic amenities and collecting revenues from city population). Focus here is squatter settlement in Mankhurd areas and its population living in slums. Some sections have very high population density. An attempt has been made here to know about various aspects of slum population as Information about the household, its members, living condition, and diversification of livelihood, etc. Data were collected from the head of the household or a responsible member of the household through a well designed pre-tested questionnaire.

WATER RESOURCES MANAGEMENT IN URBAN AREAS – A SUSTAINABLE SOLUTION THROUGH IBWT

Rapid urban growth threatens sustainable development when the basic pre-requisites such as sustainable and efficient domestic water supply in urban areas are not ensured. Rapid urbanization demands for a sustainable and efficient Water Resources Management for the urban areas. The availability of water is scarce with steady increase in demand of water owing to increasing population, rapid urbanization, etc. and hence there is an immense necessity to augment water availability for domestic utilization. The National Water Policy of Government of India (GOI) revised in 2012 accords over-riding priority to drinking water over other uses. National Water Policy also emphasizes the need for Inter Basin Water Transfer (IBWT) while assigning highest priority for drinking water supply needs followed by other uses. As per the census of India – 2011, the Greater Mumbai with a population of 184.14 lakhs continues to be India’s biggest city. The initial estimates of Municipal Corporation of Greater Mumbai (MCGM) indicate a gross shortage of about 1053 Mm 3 of water for the domestic requirements of Mumbai. Preliminary water balance studies carried out by National Water Development Agency (NWDA) revealed that surplus waters are available in the Damanganga basin which can be transferred for supplementing the domestic water requirements of Greater Mumbai. Detailed Project Report of D-P link project prepared by NWDA envisages construction of two dams viz., one across river Damanganga near Bhugad village and another at Khargihill across river Vagh (a tributary of Damanganga) along with two tunnels connecting Bhugad, Khargihill & Pinjal reservoirs. Based on studies it has been ascertained that about 210Mm 3 water from Bhugad reservoir and about 369 Mm 3 of water from Khargihill reservoir (total 579 Mm 3 from Damanganga basin), can be transferred to Pinjal reservoir. Thus the combined surplus waters of Bhugad and Khargihill reservoirs of Damanganga basin to the extent of 579 Mm 3 along with surplus waters available at Pinjal reservoir of Vaitarna basin (316 Mm 3 ) totalling to about 895 Mm 3 can be transferred through D-P link to Mumbai city for augmenting its domestic needs. The combined surplus waters of Damanganga and Pinjal rivers will be taken further to Mumbai city as per the planning of MCGM and Mumbai Metropolitan Regional Development Authority (MMRDA). In view of the acute scarcity & stressed water conditions prevalent owing to rapid increase in population and depletion of natural water resources in urban areas, the augmentation of domestic water needs in urban areas can be tackled effectively through IBWT.

Disaster Vulnerability Mapping for a Densely Populated Coastal Urban Area: An Application to Mumbai, India

Coastal urban cities frequently face multiple hazards, including potentially disastrous extreme events. To combat this, vulnerability assessment is essential to developing an effective mitigation strategy. This study proposes a framework to assess the vulnerability of any densely populated urban area to disasters by considering both the population and the assets that are at risk. A set of indicators is also proposed to assess the vulnerability of social and socioeconomic systems, infrastructure, critical facilities, and adaptive capacity. The components of vulnerability were evaluated individually, using an accessible open source geographic information system at a fine 1-km grid scale, providing an insight into the spatial variability of the vulnerability. The optimal weight for individual indicators was assigned using data envelopment analysis to minimize subjective judgment and establish confidence in the results obtained. To decorrelate and reduce the dimensionality of the multivariate data, principal component analysis was performed. The proposed methodology was demonstrated on the twenty-four wards of Mumbai under the jurisdiction of the Municipal Corporation of Greater Mumbai and showed the mideastern part of Mumbai as the most vulnerable—mainly due to the increase in population and the marginal workers' ratio. A reduction in social vulnerability has been observed, however, across the city through improvement in the literacy rate and the main workers' ratio.

The pitfalls of regional delineations in land use modeling: Implications for Mumbai region and its planners

In this article we use the SLEUTH model and publicly available datasets to develop a stylized planning application for Mumbai, India. We use two sets of model specifications that reflect the two regional extents at which Mumbai region is planned: (1) the jurisdiction of the Municipal Corporation of Greater Mumbai (MCGM), which is responsible for the central city and surrounding suburbs, and (2) the planning area of Mumbai Metropolitan Regional Development Authority (MMRDA), which is a loose collection of a much larger set of municipalities and districts. Using these, we illustrate how urban models can be limiting as a predictive tool but useful as an assessment mechanism, especially when additional considerations of scale and institutional roles are applied. We compare the outcomes for the overlapping geographic area between the two planning agencies and find considerable variations in the location and amount of growth and discuss why and how the differences in the spatial extents affect the model results. Through a discussion on the implications for modelers and planners, especially in light of the ongoing initiatives in India, we highlight the value of consideration of multiple model outcomes and highlight the importance of coordination of planning efforts taking place in spatially overlapping or nested jurisdictions.

Development of indicators for patient care and monitoring standards for secondary health care services of Mumbai.

BackgroundThe Qualitative aspect of health care delivery is one of the major factors in reducing morbidity and mortality in a health care setup. The expanding suburban secondary health care delivery facilities of the Municipal Corporation of Greater Mumbai are an important part of the healthcare backbone of Mumbai and therefore the quality of care delivered here needed standardization.Material and MethodsThe project was completed over a period of one year from Jan to Dec, 2013 and implemented in three phases. The framework with components and sub-components were developed and formats for data collection were standardized. The benchmarks were based on past performance in the same hospital and probability was used for development of normal range. An Excel spreadsheet was developed to facilitate data analysis.ResultsThe indicators comprise of 3 components - Statutory Requirements, Patient care & Cure and Administrative efficiency. The measurements made, pointed to the broad areas needing attention.ConclusionThe Indicators for patient care and monitoring standards can be used as a self assessment tool for health care setups for standardization and improvement of delivery of health care services.

Deforestation-induced costs on the drinking water supplies of the Mumbai metropolitan, India

The success of incorporating natural capital into resource- and land-use decisions hinges on the ability to quantify the ecosystem services, forecast the returns to the investments, convert these values into effective policy and finance mechanisms, and the presence of well-functioning institutions and infrastructure. However, ecosystem production functions i.e., the relationship between regulatory functions of the ecosystem and the economic activity it protects or supports are often poorly understood. Even with respect to Forest Watershed Services – a service that is widely recognized and even institutionalized through market based mechanisms in some parts of the world – the biophysical relationships between forests and services such as stream flow stabilization, water quality and water quantity are undefined, particularly for the tropics. For this reason, this study through time series data and multivariate analysis characterizes the relationships between Forest Cover (all lands with tree cover of a canopy density of 10% and above when projected vertically on the horizontal ground with minimum areal extent of 1ha), water quality and cost of water treatment in the Western Ghats of peninsular India. In particular, the recursive relationship between the economic and environmental components is estimated by tracing the effects through the two-stage model. Annual value of impacts (increased ‘treatment cost’, increased ‘water losses due to backwash and desludging’, and changes in ‘water yield’) induced by loss of Forest Cover is estimated as 64.96 Indian rupee/m3 treated water/ha/year ($1.32/m3 treated water/ha/year). At an annual rate of change in the forest cover by −0.0088% (average annual rate of change in the forest cover between the years 1994–2007) the deforestation induced costs translate to 3.73 million Indian rupee/year ($0.075million/year) according to the 2010–2011 prices for the Panjrapur treatment plant of the Municipal Corporation of Greater Mumbai. Thus, if deforestation is avoided the Municipal Corporation can save significant amount towards recurring costs of water treatment and to some extent mitigate the costs for the development of a new source.

Mobilising Women from a Low Income Community to Attend Cervical Cancer Screening Camps: Insights from a Study in an Urban Slum of Mumbai

Background: To increase the cervical cancer screening rate, various strategies are being conducted in the communities. The present study uses mixed interventional approach aiming to create awareness among couples about cervical cancer and Pap smear and to increase the rate of Pap smear screening. Methods: The study was carried out in collaboration with Municipal Corporation of Greater Mumbai (MCGM). The Dr Babasaheb Ambedkar Maternity Home under MCGM situated in Vikhroli, Mumbai was selected for the study. The study followed a quasi-experimental design. Women aged between 18 to 49 years and their husbands were randomly selected for the survey. Pre and post intervention survey was conducted to see the impact of intervention on creating awareness and utilization of Pap smear services. Multilevel intervention program was adopted to achieve the objectives. Results: Significant increase in awareness about cervical cancer among couples was observed from pre (5.5%) to post (97.7%) intervention survey. About 32.2% women were found to be infected with HPV. Conclusion: Mixed interventional approach is a good strategy for early diagnosis of cervical cancer.

Clinical, bacteriological, and histopathological characteristics of newly detected children with leprosy: A population based study in a defined rural and urban area of Maharashtra, Western India

Leprosy has been a major public-health problem in many developing countries for centuries. According to the National Leprosy Elimination Programme report of March 2012, there were a total of about 0.13 million cases of leprosy in India, 9.7% of which were children. Numerous studies have investigated child leprosy amongst reported cases however, studies pertaining to proportion and characteristics of undetected childhood cases in the community are very few. To examine the clinical, bacteriological, and histopathological characteristics of newly detected child leprosy cases in the community. The population survey conducted from June to September 2007 and the defined rural areas, which included five primary health centers of Panvel Taluka, in Raigad district and urban areas, which included M-east ward of the municipal corporation of greater Mumbai of western Maharashtra, India. House-to-house survey yielded 32 and 37 so far, undetected child cases of leprosy in the rural and urban region, and the prevalence rate was 10.5 and 1.5 per 10,000, respectively. The age of child leprosy cases detected, ranged from 3 to 14 years with a mean of 10.06 ± 3.35 years in the rural and 9.97 ± 3.12 years in the urban area. Most of the cases were paucibacillary (62%). A large proportion of children (49%) had single skin lesion (SSL). Of the 19 SSL cases examined histopathologically, 15 (99%) showed features of borderline tuberculoid, 1 (5%) borderline lepromatous and 3 (16%) had indeterminate type of leprosy. Tuberculoid leprosy was not seen in any, indicating less likelihood of self-healing. Overall, three cases had deformity (grade 1 = 1 and grade 2 = 2) and 31% of multibacillary cases were smear positive. The clinical, bacteriological, and histopathological characteristics of newly detected child cases in the community evidently indicate the grave nature of the problem of undetected child leprosy, recent active transmission, and highlight implications on individual patients and the community. Most of the cases were paucibacillary (62%). A large proportion of children (49%) had SSL and (55%) had it on the face followed by arms and leg (27%) and trunk (17%). The mean duration of symptoms exceeded one year which can be attributed to poor knowledge of leprosy or barriers in access to health care or its utilization.

What do they know about HIV/AIDS - Adolescents and young adults from slums in Mumbai, India

Introduction: In compliance with guidelines from NACP III, wide spread activities are continued, by public, private and NGO sectors, to enhance the level of knowledge about HIV/AIDS among vulnerable adolescent and young adult population in urban areas, in the forms of various projects, so as to facilitate positive behavioural changes among them . Present cross-sectional study, was conducted in three, representative administrative wards (namely L, K/East &amp; R/North) of Municipal Corporation of Greater Mumbai (MCGM), India, in December 2010, to assess the level of knowledge and attitudes about HIV/ AIDS amongst the adolescents and young adults. Methodology: Total 4306, adolescents and young adults representing all 28 health posts from selected wards were interviewed by 100 trained NSS volunteers of University of Mumbai, under the leadership of Department of Community Medicine, T. N. Medical College &amp; Nair Hospital. Data was analysed with the help of statistical software (SPSS). Results: Seventy-nine percent (3407/4306) and 49.81% (2145/4306), of respondents had heard about HIV/AIDS, and STI/RTIs respectively. Unsafe sexual relationship, as route of transmission is known to 51.81 % (2231/4306) respondents, whereas use of condom, as preventive measure is known to 87% (3746) of people. Only 30.05% (1294/4306) respondents know nearby testing facilities. Everybody should be tested for HIV, to reduce transmission, is believed by 93.96%, (4046/4306) respondents. Knowledge grade given to each respondent based on the score obtained by them out of total obtainable 25 score, reveals, 57.36%, (2470/4306), in poor grade. Multinomial logistic regression confi rms the signifi cant infl uence of age and education status of respondents on their knowledge and positive attitudes.] Conclusion: When compared with other relevant studies, the present status of knowledge of adolescents and young adults from slums of Mumbai appears to be poor and justifi es the need for intensifi ed efforts towards improving the same, taking into account their vulnerability. Well planned coordinated efforts of public, private and NGO sectors, would go a long way to get the desired impact. SAARC Journal of Tuberculosis, Lung Diseases &amp; HIV/AIDS 2012; IX (1) 26-34 DOI: http://dx.doi.org/10.3126/saarctb.v9i1.6962

PHYSICAL FITNESS INDEX AS A MEASURE OF CARDIOVASCULAR ENDURANCE IN SWIMMERS AND NONSWIMMERS

Background and Objective: Recreational swimming is a good way to relax, while enjoying a full-body workout and is recommended for the prevention and treatment of hypertension and cardiovascular disease. The present study compares the physical fitness in young freestyle swimmers practicing regularly and non-swimmers to measure the cardiovascular endurance. Materials and Methods: This Study was carried out at tertiary health centre of Municipal Corporation of Greater Mumbai on medical students after the informed and written consent. Sixty male medical students of age group 18 25 years fulfilling the inclusion criteria were included. Their Physical Fitness Index was calculated. The data was analysed using student

Mumbai Human Development Report 2009, (Municipal Corporation of Greater Mumbai), 2009

<b>Mumbai Human Development Report 2009</b>, (Municipal Corporation of Greater Mumbai), 2009