An Index and a Spatial Portray Of Illiteracy and Its Covariates of Chennai City Vasna Joshua and Venkatasubramanian, S., National Institute of Epidemiology (ICMR), India E-mail: [email protected], [email protected] ABSTRACT To develop an index and a smoothed map of Kriging, simultaneously considering several covariates of illiteracy for Chennai city. Zone wise illiteracy and its covariates for the year 2011 from Census of India, Corporation of Chennai and published reports were used. Data on eleven covariates for ten Zones of Chennai city were used for the analysis. The covariates were based on demography (population, average family size, proportion of slum population, proportion of illiterates, proportion of female illiteracy, proportion of births, proportion of person unemployed, proportion of tribal population) and variable explicative additional like average no. of children per government school, average no. of persons using per public water facility, average no. of persons using per public convenience. An index for each Zone was obtained using statistical technique of factor analysis. These indices for each Zone measure the relative difference between the illiteracy levels. A smoothened map of illiteracy covariates was done using Kriging technique. Four zones (z1,z3,z4,z5) had an index of above 50 (higher than average) which shows greater care should be emphasized in these zones to bring down illiteracy level. The smoothened map obtained using Kriging portrays the northern part of Chennai as higher risk of illiteracy. The map with the index could help the health managers, social scientists and policy makers to identify regions that require greater care to bring down the illiteracy level to a greater extent. KEYWORDS: mapping, illiteracy, factor analysis, Chennai City.
Spatial Ecological Analysis of Taluk-Level Satellite Particulate Matter Concentrations and Lung Cancer Incidences: A Study in the Western Districts of Tamil Nadu, India Janani Selvaraj1, Prashanthi Devi. M.1 and Harathi, P. B.2 1Department of Environmental Management, Bharathidasan University, Tiruchirappalli, India E-mail: [email protected] 2Department of Zoology, PSGR Krishnammal College for Women, Coimbatore, India ABSTRACT Globally, lung cancer is estimated to account for almost 1.4 million cases of cancer each year and has been the most common cancer in the world for more than two decades. Past reviews of the evidence regarding outdoor and household air pollution indicated that both were associated with lung cancer risk; specifically, exposures to increased levels of particles, as well as other indices of air pollution, were associated with increased lung cancer risk. The International Agency for Research on Cancer (IARC) recently concluded that exposure to outdoor air pollution and to Particulate Matter (PM) in outdoor air is carcinogenic to humans (IARC Group 1) and causes lung cancer. Numerous studies have found health effects of acute and chronic exposure to fine particulate matter (PM2.5). Air pollution epidemiological studies relying on ground measurements provided by monitoring networks are often limited by sparse and unbalanced spatial distribution of the monitors. Studies have found correlations between satellite Aerosol Optical Depth (AOD) and PM2.5. Satellite aerosol data may be used to extend the spatial coverage of PM2.5 exposure assessment. The objective of the present study was to examine the association between satellite particular matter concentration and lung cancer incidences in the western districts of Tamil Nadu. Standardised lung cancer incident rates were computed for each taluk (sub-district) for the time period 2001-2013. The mean PM2.5 raster grid for the decadal time period 2001- 2010 was acquired. Other covariates including smoking prevalence rates were also incorporated into the study. A comparative analysis including three regression models (ordinary least squares, spatial lag and spatial error) were used to assess the relationship between PM2.5 and lung cancer incidence rates. The results provide a significant relationship between the aerosol particle concentrations and lung cancer incidences and also correlated with the age standardised cigarette smoking rates. The evidence of the present association study would support targeting of policy interventions on such areas to reduce air pollution levels. Remote sensing particulate matter concentrations could be used as an alternative health-related indicator of air-quality. KEYWORDS: Lung Cancer, PM2.5, spatial regression
Spatial Analysis of Population at Risk through Estimation of PM2.5 Exposure Index Janani Selvaraj,1 Anupama Natesh,2 Prashanthi Devi. M1 Harathi P. B.3 and Hemanth Kumar H.4 1Department of Environmental Management, Bharathidasan University, Tiruchirappalli, India 2NITTE, Karkala, Bengaluru, India 3Department of Zoology, PSGR Krishnammal College for Women, Coimbatore, India 4Karnataka State Council for Science and Technology, Indian Institute of Science, Bengaluru, India ABSTRACT There is an increased concern among policy makers regarding the escalation of particulate pollutants in urban cities around the world. Particulate matter (PM) is a primary air pollutant and includes all solids and/or liquids (dust and mists) suspended in the atmosphere and may or may not be visible as soil particles, soot, lead, and so on. The microscopic particles serve as binding surfaces for various chemicals which when inhaled causes various adverse health effects. Air pollution exposure assessment studies in relation to health are limited in developing countries like India, due to their widespread geographical coverage, increased urban population sprawl and limited number of air pollution monitoring stations. These gaps can be reduced by implementing various geospatial approaches. Spatial analysis is helpful in providing an estimate of vulnerable population at risk to different concentration of PM2.5, thereby highlighting the spatial distribution of ambient air quality in a locality and quantifies the average exposure of vulnerable group to prevailing ambient air quality. The present study aims to develop a population weighted exposure risk index which combines total number of vulnerable people and air quality value for a particular area. The remotely sensed PM2.5 grid datasets were extracted for the Tamil Nadu region. The mean PM2.5 concentration for each taluk was computed and classified according to four classes based on the WHO guidelines. The vulnerable age group population densities including 0-14 and 60+ age strata were calculated for each taluk using the Census of India reports. An exposure index was computed for each taluk as the sum product of the air quality measure and the population of vulnerable group per unit area. The resulting map is a population weighted PM exposure index. Thus, places with high PM values and high population of vulnerable group results in higher exposure index values. This value represents the average concentration exposed to by the population of each taluk. The results indicate areas with varying levels of exposure index. High exposure could be attributed to a combination of high PM concentration and high population density. With this, it is possible to deduce at the local level where vulnerable people intersect with areas of low air quality. Moreover, areas with sparse population have a relatively low exposure index value. The study presents a method which could be used for regional or national planning for environmental and health policy decision making. While this information is necessary for rapid assessment of environmental health risk, it is also important the effort be made to explore indoor air quality as well as the interaction of other socio-economic, demographic and physiographic attributes on development of pulmonary and cardiovascular problems. Research on the computation and exploration of other risk measures such as relative and attributable risks would further enhance policy making in relation to environmental health. KEYWORDS: PM2.5, exposure index, vulnerability
Spatio-Temporal Epidemiological Pattern of Breast Cancer - A Case Study of Southern Karnataka, India Madhu B1, Srinath K M2, Vidyalakshmi R, Prashanthi Devi M3, Ashok N C1, S Balasubramanian4 1Department of Community Medicine, JSSMC, JSS University, India E-mail: [email protected] 2Department of Medicine, JSSMC, JSS University, India 3Department of Environmental Management, Bharathidasan University, India 4Dean Faculty of Life Sciences and Director Research, JSS University, India ABSTRACT Spatio- ecological studies and demographic studies of disease provide a framework to study people’s lifestyles and how it affects health (Cromley and Mc Lafferty, 2002). As a part of the health Initiatives, the government aims to improve the health disparities, integrate communication and health and use information technology as a priority to elevate community health. Public health practitioners can use GIS as a Spatial visualization tool to effectively present geographic phenomenon and depict it in maps that might remain otherwise undiscovered in tabular form (Cromley and Mc Lafferty, 2012) and can transfer the information to health managers for effective planning. In the present paper, we demonstrated how GIS can be used to understand and communicate health data through spatial visualization. A total of 1090 breast cancer case records collected for the year 2007-2012 were segregated taluk wise for the 29 taluks and geo-coded using address of the patient, creating a point map. Arc GIS 10.2 software was used to prepare thematic map of breast cancer cases. The taluk wise aggregated breast cancer incidence from the year 2007 to 2011 was then attributed into polygon map representing taluks which is considered as the base map of the study. Natural break data classification technique was used to classify breast cancer incidence data and breast cancer incidences were classified as low, moderate, high and very high. Spatial distribution of breast cancer incidences is prepared and presented as map in Map 1 and to represent the temporal distribution of breast cancer maps 2 to maps 6 are prepared and presented. Through this method, a scientific approach into the processes that promote the temporal fluctuation of disease can be evolved. Advancement of GIS technology makes it easier to connect spatially referenced physical and social phenomenon to population pattern of health and disease on a time scale and thus provides a decision supporting system for medical sciences, information for cancer control interventionist and geo-demographic data for control and prevention activities. KEYWORDS: Spatio- Temporal Epidemiological Pattern, Breast Cancer, Southern Karnataka
Healthcare Accessibility and Geospatial Analysis - A Case of Greater Mumbai Rupanjali Dasgupta1, Dipti Mukherji1 and Souvik Bandopadhyay2 1University of Mumbai, Kalina, Santacruz (East), India E-mail: [email protected], [email protected] 2Geospatial Analysist, Kolkata, India, E-mail: [email protected] ABSTRACT Health GIS has become exceptionally useful in comprehending the larger picture of public health as this discipline holds a significant capacity to understand both differences and similarities in the health of population, the impact of health issues on the people and the trends by which they are affected across the world. This practical approach favored the progressive health system in analyzing medical and epidemiological phenomena. The changing spatial organization of healthcare and spatial health disparities is significant for public healthcare management. Various amorphous issues encapsulates health concerns like health infrastructure, diseases and services, posing to ‘’ health challenge’’. Facilitating healthcare resources to the urban population is important for preservation or improvement of their health. Access to healthcare facility is a complex concept, which means access to services. The extent to which a typical healthcare facility is accessed, depends on financial, organizational and social and cultural aspects that limit the utilization of this services. Healthcare services depends on affordability, physical accessibility and acceptability. The equity of healthcare services can be divided in terms of availability. There is a disparity in healthcare facility in urban areas. The paper would discuss on geospatial analysis of healthcare accessibility in Greater Mumbai. The paper also would highlight the public health systems and suggest the planning and decision making for the purpose with specific reference to healthcare services which is already existing in Greater Mumbai and discuss the pros and cons of this sector. KEYWORDS: Healthcare, Geospatial Analysis
Atypical Infiltrating Ductal Carcinoma –A Case Report Surya, B. and Murali, R. Chettinad Hospital & Research Institute, India, E-mail: [email protected] ABSTRACT Infiltrating ductal carcinoma (IDC) is one of the most common forms of breast cancer contributing to about 70 -80 % of breast carcinomas. Breast carcinomas have a wide etiology, risk factors and various modes of presentation. In the case of IDC, the typical presentation includes nipple discharge and/or any under arm mass. The following case study is of a 44 year old female who presented to the OP with complains of pain and nipple discharge from right breast since 3 months. On examination, milky discharge from the right nipple was noticed, along with signs of mastitis and a palpable mass measuring 2x2cm. Associated palpable axillary lymph nodes were also felt. The patient underwent routine investigations including CBC, mammogram and biopsy. Once diagnosis of IDC was confirmed, patient underwent the recommended treatment which is a simple mastectomy followed by radiotherapy to prevent lymphatic spread, and finally coupled with chemotherapy to prevent recurrence. However, even with intensive treatment, the prognosis was poor and unfortunately the patient succumbed to the illness shortly after surgery. This case report demonstrates the importance of atypical presentations of IDC and the importance of detecting these atypical cases earlier to prevent mortality. In this case, if this patient had presented earlier, and mastitis was taken as a warning sign, the carcinoma could have been detected in the earlier stages, and conversion of non-invasive to invasive could have been prevented. No matter the presentation of the breast cancer, proper detection and diagnosis is essential for the prevention of an invasive type of cancer to metastatic changes of cancer. Consistent pathologic evaluation of breast tissue is important for optimizing diagnosis and treatment, especially in atypical presentations of breast cancer. While breast cancer is a daunting reality for many women, with early detection it is a very treatable disease. KEYWORDS: Infiltrating ductal carcinoma, non-invasive to invasive, mastitis, prevention.
Technical Session: 3 30 Emerging Disease 35 36 Prevalence and Spatial Epidemiology of Chronic Obstructive Pulmonary 37 Diseases in an Industrial Town of India: An Interim Analysis 38 Arun Kumar Sharma, Kalra, O. P., Saini, N. K., Mukesh Kumar and Sulabh 39 Saini 40 41 Spatiotemporal Mapping of Cervical Cancer Incidence in Songkhla, Thailand Shama Virani, Jun Zhaoand and Hutcha Sriplung Poisson Probability Mapping Of Breast Cancer for Small Estimates in a Region Madhu, B., Srinath, K. M., Vidyalakshmi, R., Prashanthi Devi M., Ashok, N. C. and Balasubramanian, S. Facilitating Service Reach and Management of Anemia in Adolescent Girls through Application of GIS and Process Digitization Tasneem Raja, Sandeep Chavan and Nishant Maloo Cerium: A Rare Earth Metal That Could Make Caries Rare??? “Effect of Application of Cerium Chloride on Mineralization and Carious Lesion Progression in Human Enamel Invitro” Revathi Jaisingh, Raghavendra Shanbhog and Nandlal Bhojraj Mapping and Analysis Of Fluoride Hazard in Integrated Dharmapuri District using GIS Latha, K. C., Manjula Devi, Prashanthi Devi M. Balasubramanian, S. IOTN Index Based Perceptions of Orthodontic Treatment Need Among Children, Their Parent and Orthodontist: A Spatial Study of Mysore Rural Taluk Bhagyalakshmi, A. and Shivalinga, B. M. Malaria on a Global Forum: A Peek into Dental Implications Anitha Subbappa
Prevalence and Spatial Epidemiology of Chronic Obstructive Pulmonary Diseases in an Industrial Town of India: An Interim Analysis Arun Kumar Sharma*, Kalra, O. P.**, Saini, N. K., Mukesh Kumar and Sulabh Saini Department of Community Medicine, University College of Medical Sciences, India **Pt B D Sharma University of Health Sciences, India E-mail: [email protected]* 1. INTRODUCTION Chronic Obstructive Pulmonary Diseases (COPD) is the fourth leading cause of death worldwide. Low and middle income countries shoulder much of the burden of COPD (McKay, A. J., et al., 2012). The global prevalence of the disease in 1990 was 9.34/1000 in men and 7.33/1000 in women (Pauwels, R., 2001). COPD is a major public health problem in India also. By 2016 it is expected that there will be 22.2 million cases in the country. However, burden of disease estimation for COPD in India is not available and the current prevalence is not well understood (McKay, A. J., et al., 2012). McKay et al recommended that accurate estimates of current/future disease prevalence are required for optimal strategies to mitigate growth and effects of disease to be devised and thorough standardized prospective studies are required in various sub populations. Literature search shows that more often studies are based on hospital data or data collected from small geographical areas covering a very small population. Even district or state level estimations are absent from published literature. From 1964 to 1995, studies conducted in male population of northern India showed prevalence between 2.12 to 9.4%, and in females in the same area from 1.33 to 4.9%. The corresponding values from south Indian population were 1.4 to 4.08% and 2.55 to 2.7%. These studies having spread over 30 years do not really reflect the true epidemiological profile of COPD in India, it also points at the incompleteness of data as well as its lack of representativeness in terms of geographical and environmental heterogeneity which significantly determines the distribution of COPD. Murthy & Sastry, based on these studies, in 1995, in their background paper for NCMH projected 147 lakh male and 75.1 lakh female patients of COPD in 2016. However the authors state that precise estimates of COPD cannot be done due to absence of data and mortality rate among COPD patients is not available (Murthy and Sastry, 2005). In order to fill up this gap in knowledge about true estimates of prevalence of COPD, we conducted this study to determine the prevalence of COPD in a district which has industrial, urban and rural habitations. In this paper we present data o interim analysis of this ongoing study. 2. MATERIALS AND METHODS using a validated questionnaire developed The study was carried out in Ludhiana by Jindal et al 2012. Based on the district of Punjab. A cross sectional questionnaire based screening, all community based survey was conducted. suspected cases were confirmed by So far survey has been completed in spirometry and prescriptions, if any, industrial area and partially in urban available with a patient from a qualified residential area of the city. In all selected physician or hospital. GOLD guidelines colonies, door to door survey was carried based on spirometry were used for out for identifying persons suffering from confirmation of diagnosis of COPD (Global COPD. Screening of cases was done by Initiative for Chronic Obstructive Lung
Disease, 2015). Maps of surveyed areas Spatial epidemiology of COPD is being were obtained from Survey of India and presented in this paper. additional information was obtained from Google Earth Maps. The location of each 3. RESULTS patient was geocoded using Trimble Juno In Industrial area of Ludhiana, 1999 SA handheld GPS device. Data was households were surveyed covering a total managed using Microsoft Excel population of 9509 and in Urban area, 8128 spreadsheet. ESRI ARC GIS10.2 was used for persons were surveyed in 1900 households creating digital maps and carrying out in urban residential areas of the city. spatial statistical analysis. Surveyed area along with location of cases is shown in Figure 1. Figure 1: Map of Ludhiana showing surveyed area and location of cases
In all 56 confirmed cases of COPD were are 4.20/1000 and 1.96/1000. This difference identified, of which 40 were in industrial is statistically significant (p < 0.008). The area and 16 in urban residential areas. The colony wise prevalence is depicted in overall prevalence was 3.17/1000 Figure 2. Density mapping of COPD is population. The respective prevalence shown in Figure 3. rates in industrial and non-industrial area Figure 2: Colony wise prevalence of COPD in Ludhiana Figure 3: Density Mapping of COPD
Continuous monitoring of air quality air quality and COPD, the results of PM2.5 monitoring data is not available for kriging are shown in Figure 5. Ludhiana, however cross sectional one time data is available from 15 sites, 4. DISCUSSION collected in February – March 2013 as This study is being conducted to determine shown in Figure 4. PM2.5 data was obtained the prevalence of COPD in an industrial from Environmental quality monitoring town of north India. The overall prevalence reports of 43 critically polluted areas 2013 was found to be 3.17/1000 total (Central Pollution Control Board, 2015). Etio- population. Other studies in similar pathologically, PM2.5 being the most population groups have taken the important indicator of association between denominator to be above 35 years or 40 years of age. Figure 4: PM2.5 levels at 15 monitoring sites Figure 5: PM2.5 interpolation and location of cases
In our study we found cases as young as 31 high. Detailed mapping of COPD cases will years of age, so after adjusting for age, the help estimate true burden of COPD as well prevalence in our study was found to be as determination of location of cases, 6.9/1000 which is much less than what has which will help in better management and been reported in previous studies. Jindal et planning of prevention for COPD. al., 2012 in a multicentric study reported a prevalence of 4.1%. But this study is only REFERENCES questionnaire based and covers population over 35 years of age. One of McKay, A. J., Mahesh, P. A., Fordham, J. Z. the center for this study is Chandigarh, located about 100 km Soth-East of and Majeed, A., 2012, Prevalence of Ludhiana, which has socio-culturally similar population, but separate prevalence rate COPD in India: a Systematic Review. is not reported in the study7. Further this study was conducted in 2005, over 9 years Prim Care Respir J. Sep; 21(3):313-21. the prevalence of an environment related disease may change. For the same reason, doi: 10.4104/pcrj.2012.00055 we did not attempt to compare our findings with other studies conducted in in Pauwels, R., Buist, A., Calverley, P., Jenkins, 1990s or even earlier. However, the in our study probability of underreporting cannot C. and Hurd, S., 2001, Global Strategy be ruled out. The difference in density of cases between industrial and non-industrial for Diagnosis, Management and area is evident in the maps. Prevalence calculated in different colonies also Prevention of Chronic Obstructive suggested that cases are more densely located in colonies in industrial areas as Pulmonary Disease. NHLBI/WHO Global compared to urban areas. Thereby implying that COPD cases are more Initiative for Chronic Obstructive Lung concentrated in industrial zones and industrial pollutants may have a more Disease (GOLD) Workshop Summary. detrimental effect on respiratory health of residents compared to environmental Am J Resp Crit Care Med2001; 163: pollutants generated from vehicular emission in residential areas of the city. 1256-76. However, this needs to be substantiated with more data based evidence. Murthy, K. J. R. and Sastry, J, G., 2005, In spite of limited scope of interpretation, we looked at the 2013 PM2.5 data available Economic Burden of Chronic from 15 sites and created an interpolation map with simple kriging. But it failed to Obstructive Pulmonary Disease. National show any pattern of association with respect to aggregation of cases. A better Commission on Macroeconomics and understanding may be developed once we have collected data from remaining Health Background Papers – Burden of urban and rural areas of the Ludhiana district. Disease in India. National Commission 5. CONCLUSIONS on Macroeconomics and Health, It is very likely that high concentration of cases of COPD will be found in residential Government of India, 2005. Available neighborhoods of air polluting industries, particularly where PM2.5 concentration is from: http://www.who.int/macrohealth/actio n/NCMH_Burden%20of%20disease_%282 9%20Sep%202005%29.pdf Jindal, S. K., Aggarwal, A. N. and Gupta, D., 2012, Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults (INSEARCH). Int J Tuberc Lung Dis. 2012 Sep; 16(9):1270-7. Global Initiative for Chronic Obstructive Lung Disease, 2015, Pocket Guide to COPD Diagnosis, Management & Prevention. Available from http://www.goldcopd.org/uploads/user s/files/GOLD_Pocket_2015_Feb18.pdf Central Pollution Control Board, 2013, Sampling and analysis of ambient air quality and water quality in selected industrial/cluster areas. New Delhi, India. http://www.cpcb.nic.in/divisionsofhead office/ess/env_criti43_2013.pdf accessed on 28 April 2015.
Spatiotemporal Mapping of Cervical Cancer Incidence in Songkhla, Thailand Shama Virani, Jun Zhao and and Hutcha Sriplung Prince of Songkla University, Songkhla, Thailand E-mail: [email protected], [email protected], [email protected] ABSTRACT Cervical cancer incidence has steadily decreased in Songkhla province since the implementation of screening. However, within the province, there is considerable variation across the 16 districts, particularly in the 3 districts that are comprised of a high percentage of Muslims. The objective is to identify spatial and temporal variations by mapping the incidence of cervical cancer in Songkhla province over a time span of 25 years. Incidence rates of cervical cancer were determined from the Songkhla population-based cancer registry. Age-adjusted rates were calculated using census data and adjusted to the modified Segi world standard population. Bayesian hierarchical modeling using Integrated Nested Laplace Approximation (INLA) was implemented to conduct spatial analysis with smoothing techniques. There were 2,492 cervical cancer cases diagnosed in Songkhla province from 1989-2013. Age-standardized incidence rates (ASR) increased by 1.9% per year until 2000 and then decreased rapidly by 4.3% per year. There are three epicenters of incidence across all time periods with the highest incidences of cervical cancer. The biggest one covers Sadao, one at Hat Yai, and the smallest one at the juncture of Mueang Songkhla and Singha Nakhon. The three districts in the south that are predominantly Muslim had consistently lower incidence rates compared to all other districts across all time periods. Occasional screening prior to implementation of national screening seems to have proven effective in detecting cancer incidence as evidenced by the increase in ASR prior to 2000. Continuous screening through the national program has been effective in maintaining the decrease in incidence. Although ASRs have decreased across all districts in Songkhla over time, Sadao, Hat Yai and the juncture of Mueang Songkhla and Singha Nakhon have higher incidences of cervical cancer compared to other districts and should be targeted for screening education and execution. KEYWORDS: Incidence, Spatiotemporal, Bayesian
Poisson Probability Mapping of Breast Cancer for Small Estimates in a Region Madhu, B.,1 Srinath, K. M.,2 Janani Selvaraj,3 Prashanthi Devi M.,3 Ashok, N. C.1 and Balasubramanian, S.4 1Department of Community Medicine, JSSMC, JSS University, India E-mail: [email protected] 2Department of Medicine, JSSMC, JSS University 3Department of Environmental Management, Bharathidasan University 4Dean Faculty of Life Sciences and Director Research, JSS University ABSTRACT Small numbers problem is probably the most pervasive problem in disease mapping. The Problem arises when the absolute number of cases of the disease in each area is small, either because the areas are very small or the disease is comparatively rare or both. When used as numbers to calculate rates, small numbers may provide very misleading impressions of the underlying risk. Poisson Probability maps provide one solution to this small number problem. Probability mapping is a geo-statistical method that accounts for spatially varying population sizes and spatial patterns in the process of analysing cancer incidence data. Probability mapping model was developed to indicate the likelihood that the rate observed in that area would occur by chance if there is a constant risk of disease which can be extended to the entire area. According to Choynowski (1959), the disease counts are considered as independent poisson random variables, the probability of any observed disease count is calculated for each region/county using the poisson distribution and the cumulative probabilities derived from Poisson distribution are an index of deviation from the null hypothesis of equal risk and the probability value ranges from 0 to 1 and the probabilities are depicted on a choropleth map for visualizations. The expected probability values were integrated into the taluk map and the results were mapped in R software. The likelihood of low to high occurrence of breast cancer is depicted in the map1. Poisson Probability mapping is a useful way of addressing the small number problem when mapping area-level health data and probability map approach standardised the incidence re-expressing them as a ratio of the estimated number of breast cancer cases and number that would have been expected in a standard population. KEYWORDS: Poisson Probability Mapping, Breast Cancer, Risk, Southern Karnataka
Facilitating Service Reach and Management of Anemia in Adolescent Girls through Application of GIS and Process Digitization Tasneem Raja,1 Sandeep Chavan2 and Nishant Maloo3 Tata Trusts, India, E-mail: [email protected],1 [email protected],2 [email protected] ABSTRACT Anemia is a significant public health challenge in India. It has devastating effects on health, physical and mental productivity; thereby, affecting quality of life, particularly among the vulnerable. India reports a high prevalence of anemia in adolescent girls and there is a dire need to break the intergenerational cycle of nutritional impoverishment. This paper is based on the experience of service provision in 22 clusters across 9 districts of Eastern Uttar Pradesh. Adolescent girls in the age group of 15-19 years were screened for anemia and taken through the appropriate protocol. Understanding data and incorporating it during planning is central to effective community based programs. Tools such as community-based resource mapping are visual tools, which help frontline workers and community members understand patterns of vulnerability, accessibility of resources, key structure for public utility, etc. Maps produced from GIS data can be used to depict relationships and significant hotspots within a community and can be extremely important for public health mangers to analyze data. GIS maps can be more user-friendly than other forms of data presentation; thus, helping community-based organizations (CBOs) and public health managers understand community data and facilitating a better understanding of the community needs, choice of intervention, etc. The paper focuses on the challenges of reaching services to clusters of adolescent girls in areas with inefficient service reach, whilst discussing the use of technology such as GIS, its efficacy and challenges in community based health programs.
Cerium: A Rare Earth Metal That Could Make Caries Rare ??? “Effect of Application of Cerium Chloride on Mineralization and Carious Lesion Progression in Human Enamel Invitro” Revathi Jaisingh,1 Raghavendra Shanbhog2 and Nandlal Bhojraj3 JSS University, India, E-mail: [email protected],1 [email protected],2 [email protected] ABSTRACT Reduction in caries prevalence is largely attributed to fluoride. Apart from its positive effects, fluorides in high concentrations demonstrated side effects. Hence there is a need for newer preventive measures with potentially lesser adverse effects. Previous animal studies done using Lanthanide solutions for prevention of caries like lesions showed that Cerium (A member of lanthanide series and a rare earth element that resembles calcium) in combined application with amine fluoride reduces mineral loss and lesion progression. Cerium showed lower toxicity than fluoride. Till date, in literature, effect of cerium chloride on human enamel has not been studied. The aim of this in vitro study is to assess the effect of cerium chloride on mineral loss, lesion progression and remineralisation of human enamel. Human enamel samples were be allocated into two groups; Group A - control, Group B- cerium chloride. All the enamel samples from two different groups were stored in a demineralizing buffer solution for 7 days to induce caries like lesions. The samples were then assessed for demineralization and lesion progression using Quantitative Light Induced Fluorescence. The samples were then treated with the respective solutions for 30 seconds, and subjected for demineralization again for 7 days. Once again the samples were assessed for demineralization and lesion progression after which the samples were subjected to a cycle of remineralisation for 14 days. The samples were then evaluated for remineralisation and lesion progression and the data was correlated with appropriate statistics. The results were consistent with that of previous animal studies which showed that cerium chloride significantly reduces demineralization especially under acid attack and has a property of remineralization as well.This property of this rare earth element can be put to maximum use in prevention of mineral loss from the tooth in carious lesions. KEYWORDS: cerium chloride, enamel, fluoride, QLF
Mapping and Analysis of Fluoride Hazard in Integrated Dharmapuri District using GIS Latha, K. C.,1 Manjula Devi2, Gangohtri, T. S.,3 Yamuna, S. R.,3 Prerana, M.1 and Balasubramanian, S.,1 1JSS University, Mysuru, India 2Bharathiar University, Coimbatore, India 3JSS Dental College, Mysuru, India ABSTRACT Fluoride in ground water has drawn global attention due to its considerable impact on human health. Different forms of fluoride exposure are of importance and have shown to affect the body's fluoride content and thus increasing the risks of fluoride-prone diseases. Fluoride in drinking water is known for both beneficial and detrimental effects on health. The presence of Fluoride in exceeding WHO limits (1.5 mg/l) and its related problems are prevailing in many parts of India. According to the World Health Organization (WHO), 1.1billion people in low and middle-income countries lack access to safe water for drinking, personal hygiene and domestic use (WHO, Nov. 2004). This number represents more than 20% of the world's population. Of this 1.1 billion people, nearly two-thirds live in Asia. In sub- Saharan Africa, 42% of the population is still without improved water. In order to meet the water supply MDG target for 2015, an additional 260,000 people per day should gain access to improved water sources. It is noteworthy here to mention that by 2015, the world's population is expected to increase every year by 74.8 million people (WHO, Nov. 2004). A few epidemiological studies having attempted to assess the risks of excess fluoride related diseases directly. However, the gaps could only be regarded as important if there were good reasons to suspect an effect of fluoridation from our knowledge of biochemistry and toxicology. The present study was conducted in Dharmapuri district of Tamil Nadu (11°45ˈh 12°53N and 77°13ˈ to 78°45). Fluoride content for 142 wells were collected analyzed and geocoded. The thematic map provides high, moderate and low risk areas in the Dharmapuri district also the areas exceeds the WHO limit (1904.72 sq.km) and BIS limit in drinking water. From the study it is concluded it is easy for the decision makers to provide alternate source of drinking water to the population and also to develop management strategies for the affected area. Fluoride is a component of water and as a source of contamination cannot be identified easily, a better procedure is required to visually interpret the analytical outcomes. User friendly and easy comprehendible approach, to understand the risk areas and to reach out immediate suggestive measures mapping of such risk is necessary. Maps provide an added dimension to data analysis which brings us one step closer to visualize the complex pattern and relationships that characterize real world planning and policy problems. Visualization of spatial analysis also supports different change pattern, which is important in monitoring the water quality problems. This study uses unique capacity of Geographical Information System (GIS) is that it is a powerful database linking tool, where complicated problems can be solved with better quality information and greater ease.
IOTN Index Based Perceptions of Orthodontic Treatment Need Among Children, Their Parent and Orthodontist: A Spatial Study of Mysore Rural Taluk Bhagyalakshmi, A. and Shivalinga, B. M. Dept. Of Orthodontics & Dentofacial Orthopedics, JSS Dental College & Hospital Constituent college of JSS University, Mysuru, India, E-mail: [email protected] ABSTRACT To evaluate the aesthetic perceptions of 12 year old children and their parent for Orthodontic Treatment Need and to compare their perception with that of Orthodontist. The sample consist of 100 children aged 12 years. The self-assessment by children and the recording by one of their parent and orthodontist were carried out using the Aesthetic component and Dental Health Components of IOTN. The results showed a strong association in the perception of dental appearance by children and the views of other dental assessors. These correlations were highly statistically significant (p<0.001) with the highest correlation between the parent and the Orthodontist (r=0.653). The study also focused that about 50% of the children were in the “definitive need for orthodontic treatment”. There is a strong relationship in the perception of dental appearance by children, parents and orthodontist. IOTN index can thus be used as an effective tool in communication and achieving realistic treatment needs. KEYWORDS: IOTN, Aesthetics, Perception, Orthodontist
Malaria on a Global Forum: A Peek into Dental Implications Anitha Subbappa Dept. of Periodontics, JSS Dental College & Hospital, JSS University, Mysore, India ABSTRACT Malaria is an infectious disease that is caused by a parasite called Plasmodium through the bite of a type of female mosquito that carries the parasite. Half of the world population resides in malaria-prone areas, and the disease is responsible for more than a million deaths annually. In addition, to the overt clinical signs and symptoms, the association of malaria with other diseases such as tuberculosis and HIV infection has been described. However few studies have attempted to investigate its relationship to oral diseases. Oral manifestations: Clinical signs may include oral dryness; tongue sticking to palate; pallor of tongue due to anemia, difficulty with mastication, swallowing, or speech; impaired taste; thirst; licking of lips; and burning and soreness of the mucosa and tongue. A lack of saliva and its association with immunoglobulins, electrolytes, and protective benefits can contribute to discomfort, difficulty eating and swallowing, and increased risk of caries. Untreated xerostomia increases oral biofilm development, which causes gum disease, tooth loss, and caries. Some side effects of anti malarials on oral mucous membrane have been reported. Dental professionals play a vital role in some aspects. A thorough knowledge on oral implications, side effects of antimalarial medications are essential for adequate diagnosis, infection control & treatment are required. Because malaria is a worldwide disease affecting millions of people, more research is needed to further explore the oral signs and symptoms of malaria and associated diseases. Dental hygienists are well suited to aid in the research of malaria infections, their oral implications, and effective mouth care for individuals who have malarial infection. This review provides an overview of the relevance of malaria to the oral cavity. The need for further research is also emphasized.
Technical Session: 4 Health and IT - Student Session Cholangiocarcinoma Prevalence and Spatial Analysis of Geographic 43 Information System, Roi Et Province, Thailand 44 Jesada Surawan, Witthaya Radmad, Phaiboon Pensuwan and Choosak 45 Nithikathkul 46 47 DHF Surveillance Model in Sri Sa Ket Province, Thailand 46 Klarnarong Wongpituk, Siripen Kalayanarooj, Anothai Trivanich, 48 Pacharamon Promsuan and Choosak Nithikathkul 49 50 Prevalence and Spatial Distribution of Opisthorchis viverrini in Si Sa Ket 51 Province, Thailand Wilas Kampangsri, Pipat Reungsang, Pacharamon Promsuan and Choosak Nithikathkul Epidemiology of Opisthorchis Viverrini by using Geographic Information System in Roi-et Province Wilas Kampangsri, Pipat Reungsang, Pacharamon Promsuan and Choosak Nithikathkul Using Geographic Information System in Mapping Risk Zones of Leptospirosis, Thailand Sravan Sajja and Nitin Kumar Tripathi Meaningful use of Electronic Health Record: A Patient Centered Health Care Perspective Devesh Dubey and Priya Thomas Understanding Spatial-Temporal Patterns of Cholera using Geographic Information System and Statistical Methods Shuchi Mala and Mahesh Kumar Jat Healthcare Technology – Applications of Telemidicine in Rural Healthcare Settings Bharath Gavini and Mohanraj Rathinavelu Assessment of Road Safety Knowledge and Practices among Undergraduates in a Medical College in Kancheepuram District, Tamil Nadu Christina Christopher and Murali. R. Real Time Cardiac Monitoring System using Wearable Sensors Priyanka Kakria, Nitin Kumar Tripathi and Peerapong Kitipawang
Cholangiocarcinoma Prevalence and Spatial Analysis of Geographic Information System, Roi Et Province, Thailand Jesada Surawan1, Witthaya Radmad2, Phaiboon Pensuwan2 and Choosak Nithikathkul1 1Tropical and Parasitic Diseases Research Unit, Graduates Studies Division Faculty of Medicine, Mahasarakham University, Thailand, E-mail: [email protected] 2Roi Et Hospital, Muang, Roi Et, Thailand ABSTRACT Liver cancer and cholangiocarcinoma (CHCA) are importantly public health problem which is one of the top five causes of cancer patients, and number of patients continually increases, especially in the northeastern Thailand. CHCA diagnosis is presumed based on clinical signs of biliary obstruction, abnormal liver function tests, elevated tumor markers and ultrasonography, especially in intrahepatic CHCA. The most common cause is liver fluke infection. Cancer incident prevention is more important than others. Methods: This study investigated CHCA prevalence and population database of Roi Et province under the cancer unit, Roi Et hospital. There is the geographic information during 2010 to 2014 by presenting the spatial analysis. Roi Et province is located in the middle of the northeastern region, between Lat 15 24 N to 16 19 N and Long 103 16 E to 104 21 E. The distance from Bangkok is about 512 kilometers, and total area is 8,299.46 square kilometers (or 5,187,156 acres). It is divided into 20 districts, 193 sub-districts, and total population is 1,319,429 people: 658,266 male and 661,163 female. CHCA databases were investigated during 2010 to 2014 from the cancer unit, Roi Et hospital where it was only one of hospitals in Roi Et that could diagnose CHCA, it was found that number of CHCA patients continually increased 541, 669, 722, 759 and 1,144 for a rate 50.79, 63.00, 68.56, 57.98 and 87.43 per 100,000 population respectively. The average of age was 63.61, 64.45, 64.70, 63.60 and 64.76 respectively. Most patients were farmer and graduated primary school. Moreover, amount of male was 2 times of female, 99 percent of all CHCA patients were the intrahepatic CHCA. The results showed that CHCA prevalence and spatial analysis of geographic information system can be applied and make an efficiency on prevention plan including health promotion, health behavior adaptation in CHCA risk population, and can be benefit to health care of the general population. KEYWORDS: cholangiocarcinoma, geographic information system, prevalence
DHF Surveillance Model in Sri Sa Ket Province, Thailand Klarnarong Wongpituk,1 Siripen Kalayanarooj,2 Anothai Trivanich,3 Pacharamon Promsuan1 and Choosak Nithikathkul1 1Tropical and Parasitic Diseases Research Unit, Graduates Studies Division, Faculty of Medicine, Mahasarakham University, Thailand, E-mail: [email protected] 2WHO Collaborating Centre for Case Management of Dengue/DHF/DSS, Queen Sirikit National Institute of Child, Bangkok, Thailand, 3Department of Computer Science, Faculty of Science, Khon Kaen University, Khon Kaen, Thailand ABSTRACT Dengue fever and Dengue hemorrhagic fever is one of the world’s most important mosquito-borne diseases affect over one hundred million people annually. Several previous reviews have broadly addressed the use of geographical information system (GIS), remote sensing (RS) and spatial modeling approaches in the field of vector-borne diseases. However, the critically important issue of the potential for such technologies and methodologies to be used for operational prevention, surveillance, and control of neglected tropical vector-borne diseases have not received the attention it deserves. The possible reason of the disease pandemic is a rare of an understanding of local people regarding behaviors and perceptions in DHF prevention and control. The project of this study were investigate the mosquito larval index for dengue haemorrhagic fever prevention and control in endemic area, Sri Sa Ket Province during the year 2014. The study showed the mosquito larva survey index from each household such as: the house index (HI) highest 57 and lowest 7, the container index (CI) highest 24 and lowest 3, and the breteau index (BI) highest 97 and lowest 7. The number of DHF patient were 95, 103, 4574, 530 and 288 in the period of year 2011 -2015 respectively. The further study with a recommendation, the geographic information tool will be utilized for DHF prevention and control by public health sectors rather than rely on the traditional case incidence data. GIS is an alternative model for predicting mosquito breeding sites and can be used for decision – making, surveillance, and the epidemiological control of DHF. KEYWORDS: Dengue Hemorrhagic Fever, Geographic Information System, mosquito
Prevalence and Spatial Distribution of Opisthorchis viverrini in Si Sa Ket Province, Thailand Wilas Kampangsri,1 Pipat Reungsang,2 Pacharamon Promsuan,1 and Choosak Nithikathkul1 1Tropical and Parasitic Diseases Research Unit, Graduates Studies Division Faculty of Medicine, Mahasarakham University, Thailand, E-mail: [email protected] 2Department of Computer Science, Faculty of Science, Khon Kaen University, Khon Kaen, Thailand ABSTRACT Opisthorchis viverrini (O. viverrini) is a continuous public health problem in Northeast Thailand. Despite continuous efforts for decades by healthcare organizations to overcome this problem, whereas the spatial analysis that associated with O. viverrini was also lack information. This study collected the secondary data from Si-Sa-Ket annual report in 2012- 2014 to investigate the prevalence of this parasite by using Geographic Information System. The district name (key) were linked between prevalence data and spatial data by using ArcGIS program. The study found that map showing outbreak of O. viverrini, covering every district in Si Sa Ket province. The highest prevalence of O. viverrini in 2012 was Wang Hin district (13.85%), Khu Kan (12.51%) and Non Koon (12.05%) respectively. In 2013, the prevalence were Non Koon (13.01%) Prang ku (6.72%) and Kantharalak (6.27%) respectively. In 2014, Non Koon, Benchalak and Phu Sing, the prevalence were 13.72%, 9.54% and 7.86% respectively. This study indicated that the geographic information system can be useful in establishing strategies for prevention and control planning. However, the geographic factors and prognostic models should to prospective study. KEYWORDS: Opisthorchis viverrini, Prevalence, Spatial Distribution
Epidemiology of Opisthorchis Viverrini by using Geographic Information System in Roi-et Province Wilas Kampangsri,1 Pipat Reungsang,2 Pacharamon Promsuan,1 and Choosak Nithikathkul1 1Tropical and Parasitic Diseases Research Unit, Graduates Studies Division, Faculty of Medicine, Mahasarakham University, Thailand, E-mail: [email protected] 2Department of Computer Science, Faculty of Science, Khon Kaen University, Khon Kaen, Thailand ABSTRACT The application of geographic information system used to classify spatial analysis outbreak of liver fluke. The northeastern part of Thailand is still endemic area of liver fluke. In particularly, Opisthorchis viverrini (O. viverrini) which is a seriously public health problem to concern. The retrospective descriptive study was conducted to carried out the epidemiology of O. viverrini infection. The data were collected from Roi-et annual report in year 2014 to investigated the epidemiology of O. viverrini and analyzed the spatial distribution by using Geographic Information System. The district name (key) were linked between prevalence data and spatial data by using ArcGIS program. The study found that the highest prevalence of O. viverrini was Pho-chai district (66.0%), Nong-phok and Thawatburi district were 40.90% and 36.36%, respectively. This study is useful in policy management to distributed resource management problems. Albeit in a limited area. This is not a comprehensive education in every district and every village. But it also found that the geographical maps are still important in terms of predicting the incidence of the disease in the future. KEYWORDS: Epidemiology, Geographic Information System, Opisthorchis viverrini Meaningful Use of Electronic Health Record: A Patient Centered Health Care Perspective Devesh Dubey and Priya Thomas Indian Institute Of Health Management Research, Bangalore India Email: [email protected] ABSTRACT EHRs (Electronic Health Records), can contribute greatly to improving care and managing the rising costs of healthcare. The use and the integration of EHRs (Electronic Health Records to increase the efficiency and effectiveness of healthcare remains a challenge. It appears that the physicians are at the center of this bottleneck. As healthcare is provided by interdisciplinary teams of clinicians and paramedical staff, collaboration and coordination are key to effective usage of EHR. Literature suggests reasons for the limited use relate to policy, financial and usability considerations, but it does not provide an understanding of reasons for physicians' limited interaction and adaptation of EHR. This paper investigates how “meaningful use” of EHR can be used to achieve patient centered healthcare.
Using Geographic Information System in Mapping Risk Zones of Leptospirosis, Thailand Sravan Sajja and Nitin Kumar Tripathi Department of Remote Sensing and GIS, Asian Institute of Technology, Thailand E-mail: [email protected] Abstract Intensive use of Remote Sensing and Geographic Information Systems in health sector had given an opportunity for healthcare authorities to identify the risk zones for different diseases through which the services can be rendered more effectively, but this work is still under tremendous pressure especially in developing countries and countries with large population, due to the limitations in data availability. When considering low mortality rate disease like leptospirosis with high morbidity are further neglected. For years healthcare authorities responded to disease outbreak by increasing healthcare facilities. Various researches have shown that increasing healthcare facilities alone cannot help in improvising service to people, but also service to the most needed by finding out risk zones to a very small scale can bring a drastic change in allocation of services by healthcare sector. So rendering services more effectively is very important. Leptospirosis is probably the world’s most widespread zoonosis of global importance. It occurs in both developed and developing countries and large outbreaks have been reported from all over the world. Leptospirosis is now being recognized as a re-emerging infectious disease. Understanding the spatial patterns of this infectious disease is a critical step for designing interventions and consequently diminishing the risk of leptospirosis transmission. This work presents risk zone identification by finding hotspots in province level in Thailand. By which healthcare authorities can have pre-planning in allocating their resources more effectively. Leptospirosis incidence data has been prepared province level for the years 2003 to 2009. Based on incidence per 100,000 classification of all the provinces into five categories is done for each year and represented on maps. By considering average incidence of all the years, risk map is prepared. These results are been verified by the map produced by using occurrence method. From the results we can see that there are eleven provinces in Thailand with leptospirosis incidence greater than 12 per 100,000 population. From these results we can investigate in the areas for the factors leading to the disease and preventive measures can be taken and most importantly healthcare service rendering will be more effective. KEYWORDS: Leptospirosis, hotspots, risk zones
Understanding Spatial-Temporal Patterns of Cholera using Geographic Information System and Statistical Methods Shuchi Mala1 and Mahesh Kumar Jat2 Department of Civil Engineering, Malaviya National Institute of Technology Jaipur Jaipur 302017, Rajasthan, India, E-mail: [email protected],1 [email protected] ABSTRACT In developing countries, cholera epidemic persists as an important public health concern. According to the factsheets of World Health Organization, Cholera can be defined as an acute diarrhoeal infection which is caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. Researchers have estimated that every year, there are roughly 1.4 to 4.3 million cases, and 28 000 to 142 000 deaths per year worldwide1 due to cholera. As reported by the National Health Profile 2015, total reported cholera cases in India in the year 2014 were 969 (provisionally). Recently, researchers have identified that there is a strong evidence for inter-annual variability and link between climatic factors such as rainfall and vector-borne diseases such as cholera. Therefore, integration of surrounding important causative factors of vector-borne diseases such as cholera along with Geographic Information System and statistical methods will further improve the efficiency of identification and prediction of disease outbreaks. In this paper, the analysis of spatial and temporal distribution of cholera cases reported in the year 2011-2012 at Civil Lines Zone, Delhi. Furthermore, acquired data was then analysed for temporal patterns and correlation with meteorological parameter such as rainfall and socio-economic factor such as age. In this study, the clustering of cholera cases in the study area is performed by using Kulldorff’s spatial scan statistic method to determine the potential areas of cholera outbreaks. There is a strong evidence for the existence of statistically significant clusters of cholera and these clusters varied over time. GIS is used to perform disease mapping, risk assessments and to analyse spatial diffusion patterns of cholera. These findings enabled us to detect and target cholera clusters suggesting that the use of geospatial information will help public health officials to take immediate actions to control the disease occurrence, its impact on society and making fast decisions related to efficient allocation of resources. KEYWORDS: Geographic Information System, Spatial-Temporal, Significant, Cluster, Correlation, Outbreaks
Healthcare Technology – Applications of Telemidicine in Rural Healthcare Settings Bharath Gavini1 and Mohanraj Rathinavelu2 Jawaharlal Nehru Technological University, India Email: [email protected], [email protected] ABSTRACT Telemedicine has the potential to help facilitate the delivery of health services to rural areas. In the right circumstances, telemedicine may also be useful for the delivery of education and teaching programmes and the facilitation of administrative meetings. In this paper references is made to variety of telemedicine applications in developing countries including telepediatrics, home telehealth, critical care telemedicine for new born babies, health screening via e-mail, and teleradiology. These applications represent some of the broad range of telemedicine applications possible. An overriding imperative is to focus on the clinical problem first with careful consideration given to be the significant organisational changes which are associated with the introduction of a new service or alternative method of service delivery. For telemedicine to be effective it is also important that all sites involved are adequately resourced in terms of staff, equipment, tele- communications, technical support and training. In addition, there are number of logistical factors which are important when considering the development of a telemedicine service including site selection, clinician empowerment, telemedicine management, technological requirements, user training, telemedicine evaluation, and information sharing through publication. KEYWORDS: Applications, logistics, rural health, telemedicine, telehealth
Assessment of Road Safety Knowledge and Practices among Undergraduates in a Medical College in Kancheepuram District, Tamil Nadu Christina Christopher and Murali. R Chettinad Hospital and Research Institute, Kancheepuram, Chennai, India E-mail: [email protected] ABSTRACT On any given day, almost 3400 people die globally due to road traffic accidents. The Global status report from WHO in 2013 estimates that in India alone approximately 231,000 people are killed due to RTAs yearly. The majority of the victims are unfortunately children, elderly and innocent pedestrians. Due to these astonishing numbers, in 2014 the UN General Assembly, in union with a dozen countries, adopted a resolution of \"Improving global road safety\". The aim of this study is to assess the basic road safety knowledge and practices among the youth in a medical college in Kancheepuram district in Tamil Nadu. The data was collected through a cross sectional study using a semi structured questionnaire which was distributed to around 300 medical students. The data collected was then analyzed using standard statistical tests through SPSS. Of the 300 students, around 170 (56.6%) were female and 130 (43.3%) were males. All students were in the age range of 20-25 years. Overall safety awareness was more among the male population (76%) as compared to the female (70%). Majority (73%) of the participants also had a decent knowledge of safe road practices such as maintaining speed limits, wearing seat belts, waiting in zebra crossings, observing traffic signals and road signs. Majority (72%) also knew that talking, listening to loud music can be distracting during driving and driving under the influence can be fatal. However, approximately 40% of these same students admitted that they don't put their knowledge to use and frequently fail to practice proper road safety. Thus this study illustrates the need not only to provide education about road safety but to provide training and instigate stronger roles of local governments to implement these safer road practices. Only then can we effectively reduce the occurrence and morbidity of RTAs.
Real Time Cardiac Monitoring System using Wearable Sensors Priyanka Kakria and Nitin Kumar Tripathi Department of Remote Sensing and Geographical Information Systems, School of Engineering and Technology Asian Institute of Technology, Thailand, E-mail: [email protected] ABSTRACT Cardiovascular diseases are the leading cause of mortality worldwide. In recent studies, medical researchers have shown that close and real time monitoring can help improve the health of cardiovascular patients. Furthermore, in public health institutions (PHIs) in developing countries, the excessive number of hospitalized patients cared for by the nursing staff represents a problem. Inside hospitals, for bed ridden patient nurses invest substantial amounts of time updating information about each patient’s health by measuring physiological vital signs using conventional machines. Technological innovations in the field of wireless communication and advancements in wearable sensor technology have enabled the evaluation in real time monitoring. In this research, a Remote Telemedicine system has been presented for monitoring of physiological parameters such as, pulse rate, blood pressure, temperature and ECG of heart prone patient by means of wireless wearable sensors and further these vital signs relayed to an intelligent data analysis alert system to diagnose abnormal and critical heart parameters. In addition, developed system also has a user friendly web interface for medical experts and nursing staff to detect the immediate vital parameters from remote patient. After receiving abnormal signs in a remote patient, immediately alarm can be transmitted to remote patient and remote hospital server through both cellular and internet. Proposed telemedicine system consists of hardware such as (1) Arduino microcontroller board, e health sensor shield and RN XV WiFi module, personal computer, smartphone and different wearable medical sensors (2) a network layer of WiFi or 3G (3) software such as Arduino IDE. The results obtained from the experiments detects the arrhythmia, hypothermia, hyperthermia, hypotension, hypotension and normal body cardiac conditions. Furthermore system showed a successful prototype with high standard of health care and low cost that monitors prone patients in real time continuously by doctors, nurses or caregivers anywhere and anytime even though the patients stay at home. KEYWORDS: Telemedicine, Real Time Monitoring, Wearable Sensors, Heart Prone Patients.
Technical Session: 5 53 54 IT for Healthcare & Telemedicine 55 56 An Empirical Study on Adoption of Digital Healthcare Practices in Urban 57 Areas 58 M. Mallika Rao, GVRK Acharyulu and M. Bhaskara Rao 59 KoboCollect in Disease Surveillance 67 Rajeev Aravindakshan Clinical Outcome, Economic Impact of Teledentistry Sushma Rudraswamy and Nagabhushana Doggalli Disease Mapping using Bayesian Model Approach in Matlab Mamatha, H. K., Divya Rao, B. J., Sridhar, R., Prerana, M., and Balasubramanian, S. Capturing of Attention using Nuerosky Bluetooth Technology Integrating with GIS Sridhar, R., Konda Reddy, Latha, K. C and Balasubramanian, S. Designing a Geospatial System for Health Management Balbir Singh and Gvrk Acharyulu Managing the most dreaded Infection Dysentery with Health Geo spatial website 1. Shridhar T. Srinivasan IAS Rtd, Yogun Gandhi Raja, Janakiraman Radhika, Babu Doraismy, Ramakrishnan Venugopal Venkatachalam and Ghouse Mohamed Shaik Geo Spatial Data Base for Managing Health Issues in Private Public Participation Mode Thiyagarajan Jayaraman Kantharaj, Mohanram Govindarajulu, Damodharan Rangama Naidu, Muralidharan Balakrishnan, Tamilarasan and Ghouse Mohamed Shaik
An Empirical Study on Adoption of Digital Healthcare Practices in Urban Areas M. Mallika Rao1, GVRK Acharyulu2 and M. Bhaskara Rao3 1KL University, India, E-mail: [email protected] 2University of Hyderabad, India, E-mail: [email protected] 3IBS, The ICFAI Foundation for Higher Education, India, E-mail: [email protected] ABSTRACT The worldwide smart connected device market is set to attain a market value of USD 735.1 bn by the end of 2015. PCs are set to drop from 28.7% in 2013 to 13% in 2017. Tablets are set to increase from 11.8% in 2013 to 16.5% by 2017, and smartphones from 59.5% to 70.5%. It is estimated, by 2017, 87% of the worldwide smart connected device market will be tablets and smartphones. Enterprises worldwide are focusing on customer engagement as the highest priority of their smart device channel strategies. Among different verticals where this change is going to be of serious consequences, health care is one sector. Patient engagement will be, by far, the highest priority of smart device channel strategies for hospitals. Digital technology is improving products, services and processes, thus impacting patient and constituent experiences, and the way hospitals work. Health care vertical is adapting to the digital revolution and growing at a rate of 15 per cent per annum. Much inefficiency in delivery of health care services can be eliminated with technology interface. It is expected that many measurements and tests that are currently administered manually can be performed by sensors embedded in a wide range of medical devices, e.g. diagnostic equipment, drug dispensing systems, surgical robots, implantable devices, drip machines, health and fitness sensors. Thus health care delivery is all set for a paradigm shift compared to what it is today. Use of internet for searching and exchanging health information and for sharing post-treatment experiences is gaining prevalence not only in metro and urban markets, but in other markets too. Health information websites and blogs are on the rise, which is an extension or new format of the types of information that have long been provided by traditional sources of information such as newspapers or magazines. The existence of search engines and group networking sites are opening up new possibilities and raise issues of how people can ensure they are receiving quality and validated information. Health information sites provide information about healthy practices and diseases, as well as information about lifestyle, medicines and supplements. These days, it is not uncommon for health care providers to confront patients who arrive for treatment with a potential diagnosis derived from a website that has little to do with an accurate assessment of their condition. There is considerable interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementation of transformative e-Health technologies and m-health technologies are underway globally, often at very considerable cost. This empirical study examines the emergence of patient-driven health care marketing that is transforming the way health care services are delivered. Reference to other industries is made to bring in perspectives on marketing successes and determine the relevant variables for incorporation into the health care marketing models. Merits and demerits of technology-enabled health care marketing opportunities are also examined. KEYWORDS: Diffusion processes, Digital healthcare, Digital technologies, Disruptive innovations, E-Health, Health care markets, Health Informatics, Information Technology, Innovation, M-Health.
KoboCollect in Disease Surveillance Rajeev Aravindakshan Pushpagiri Medical College, Tiruvalla, India Email: [email protected] ABSTRACT It has been pointed out that data collected by the government sector is never complete. Computerization is changing the way reports are made and disseminated in disease surveillance. While government systems must be lauded for the accuracy of information thus processed, private organisations have a role to play in completeness of the intelligence derived from such reports. Involving private organizations is never easy in mundane issues such as data collection especially since return on investment is a priority for those than in public sector. For example our institute was not averse to investing in virology as a pioneer in private medical care space, it was never easy parting with the information thus gained. National Disease Surveillance Programme (NDSP) has included our institute as a sentinel for tracking many infections in the district. The information has been collected so far in the form of excel sheets and summary reports rather than any detailed spatial analysis. In this regard, the use of open software in the form of KoboCollect (R) has proven to be of immense help and the results have been collated which will be presented as graphics. KEYWORDS: Disease Surveillance, Spatial mapping, KoboCollect (R)
Clinical Outcome, Economic Impact of Teledentistry Sushma Rudraswamy and Nagabhushana Doggalli JSS Dental College & Hospital, India, E-mail: [email protected] ABSTRACT As expected, technologic innovations in the field of dentistry have been extensive in recent years. Most important advances have been made in the use of computers, telecommunication technology, digital diagnostic imaging services, devices and software for analysis and follow-up. Nowadays, it is hard to imagine a dentistry clinic without computerized patient registry, electronic invoicing, digital radiography, intraoral cameras and digital cameras. What was considered relatively distant future some twenty years ago today is the reality in dental clinics. Using most advanced information technology, the science of dentistry crosses much longer distances than it was ever able in the preceding twenty centuries. i.e. the beginning of the new era. New information technology not only improve the quality of management of dental patients, but also makes possible their partial or complete at distances of thousands of kilometres away from health care centres or qualified dentists (Kopycka-Kedzierawski & Billings, 2006). However, the primary purpose of these intelligent systems is adequate diagnosis, since the natural disease course has changed (Jevtović, 2008). These systems would not mean a lot without telecommunication assisting the process and sending information almost instantly to interested parties within an institution and all over the world. Networking, sharing digital dentistry information, distant consultations, workup and analysis is dealt with by a segment of the science of telemedicine concerned with dentistry: teledentistry. “Teledentistry’ is a synergistic combination of telecommunications technology, Internet and dental practice. It is a relatively new and exciting field that has endless potential. This paper provides a systematic review of the scientific literature in order to evaluate the efficacy, effectiveness and costs of teledentistry used for direct patient services, specifically clinical outcomes, health care utiliza¬tion and costs related to teledentistry. These outcomes were selected to reflect a common objective of teledentistry programs - to provide access to quality services while minimizing costs. Relevant databases will be searched for articles on teledentistry published until October 2015. KEYWORDS: Teledentistry, Telemedicine, Telehealth, videoconference, outcomes, dental hygiene, access to care
Disease Mapping using Bayesian Model Approach in Matlab Mamatha, H. K.,1 Divya Rao, B.J.,2 Sridhar, R.,1 Prerana, M.,1 Balasubramanian, S.1 1JSS University, Mysuru, India 2Ramakrishna Mission Vidhyalaya, Coimbatore, India ABSTRACT Analysis of spatial patterns of diseases is a particular area of interest for epidemiologists for which several statistical methods are employed. It is important to select the appropriate statistical approach for the analysis of correlated count data not only for variance estimation, but also for estimation of the mean. Use of maps to describe geographic patterns of disease is one of the most common tasks in spatial epidemiology and to describe the overall disease distribution on a map such as highlight areas of elevated or lowered mortality or morbidity risk (e.g. Lawson, 2001; Richardson, 2003; Elliot et al., 2001. In the analysis of geographically correlated data factors such as misspecification of the mean function and/ or misspecification of the probability model and also spatial autocorrelation contribute to over dispersion. To counteract the above problem Bayesian distribution is used in conjunction with Markov Chain Monte Carlo (MCMC) using logistic regression estimate. Bayesian techniques are recognised as powerful tools in disease mapping and the Bayesian approach to modeling spatial data has grown rapidly since the 1990s, providing new insights into complex spatial problems (Besag, York, and Mollie 1991; Clayton and Bernardinelli 1992; LeSage 2000. The growth of interest in Bayesian approaches to statistical analysis owes much to the development of Markov Chain Monte Carlo (MCMC) methods and softwares, The Markov chain Monte Carlo method (MCMC) was employed to obtain a sample from the joint posterior distribution of model parameters, automatically generating samples from the marginal posteriors and hyperparameters. Monte Carlo sampling allows one to estimate various characteristics of a distribution such as the mean, variance, kurtosis, or any other statistic of interest to a researcher. Markov chains involve a stochastic sequential process where we can sample states from some stationary distribution. The aim of the present study is to consider the problem of Modelling noninfectious count data in a tertiary care hospital in southern part of Karnataka. We have collected data from the hospital records for five disease viz., Diabetes mellitus, asthma, typhoid, myocardial infarction and appendicitis for seven taluks of Mysore district of southern Karnataka, India. The data was analysed using Matlab version R2011b and the results are presented. The geographical boundaries of seven taluks of Mysore is depicted as fig. 1 and the counted data for diabetes mellitus were analyzed and found. Mysore taluk has maximum cases of diabetes mellitus as one cluster and the remaining six taluks have another cluster. The same data were subjected to Bayesian analysis for a logistic model and the Bayesian inference is calculated as using Bayes theorem: P(parameters/data) = P (data/parameters) x P (parameters) α likelihood x prior P (data) The likelihood, prior and posterior distribution were calculated and presented the same as depicted in fig. 2. The study explained in the paper when applied to infectious disease data will help provide valuable answers to questions such as: -how probable a disease outbreak is -how far and how fast it will spread (in case of infectious diseases) and -how best to control it. The methodology presented here is a beginning when the data is available for several years. The model will be more fruitful and will give a high validation for health managers. The challenge for the future is to develop frameworks for integrating these disparate kinds of activity to provide more reliable and useful predictions of future disease risks.
Capturing of Attention using Nuerosky Bluetooth Technology Integrating with GIS Sridhar, R.,1 Konda Reddy2, Latha, K. C.3 and Balasubramanian, S.3 1Ramakrishna Mission Vidhyalaya, Coimbatore, India 2Projects Head, Value Soft Solutions Pvt Ltd., Bangalore, India 3JSS University, Mysuru, India ABSTRACT The beat of heart could be captured by ECG sensors, the movement of eyes could be captured by EoG sensors, the movement of muscles could be captured by EMG sensors and mind waves could be captured by EEG sensors which is called BCI. BCI systems are now being explored in applications as diverse as security, lie detection, alertness monitoring, telepresence, gaming, education art and human augmentation. The more recent surge of interest in BCI’s can be attributed to a confluence of factors: faster and cheaper computers, advances in our knowledge of how the brain processes sensory information and produces motor output, greater availability of devices for recording brain signals, and more powerful signal processing and machine-learning algorithms. EEG is Electroencephalography is a noninvasive technique for recording the signals from the brain using electrodes placed on the scalp. EEG predominantly captures electrical activity in the cerebral cortex is typically poor which is amplified by low-pass filter algorithms. There are different types of mental waves. They are Beta (13-30 Hz), Alpha (8-13 Hz), Theta (4-8 Hz) and Delta (0.5-4Hz). Gamma waves (30-70Hz) and highly Gamma waves (>70Hz). International research groups have applied wireless BCI systems for interesting new applications such as home automation system based on monitoring human physiological states, cellular phone dialing and drowsiness detection for drivers. Brainwaves are tiny electrical impulses released when a neuron fires in the brain. NeuroSky’s brain-computer interface (BCI) technology works by monitoring these electrical impulses with a forehead sensor. The neural signals are input into our ThinkGear chip, and interpreted with Attention and Meditation algorithms. The measured electrical signals and calculated interpretations are then output as digital messages to the computer, toy, or mobile device, allowing you to see your brainwaves on the screen, or use your brainwaves to affect devices behavior. The single dry sensor and reference pick up potential differences (voltages) on the skin at the forehead and the ear. The two are subtracted through common mode rejection to serve as a single EEG channel, and amplified 8000x to enhance the faint EEG signals. The signals are passed through analog and digital low and high pass filters to retain signals generally in the 1-50Hz range. After correcting for possible aliasing, these signals are ultimately sampled at 128Hz or 512Hz. Each second, the signal is analyzed in the time domain to detect and correct noise artifacts as much as possible, while retaining as much of the original signal as possible, using NeuroSky's proprietary algorithms. A standard FFT is performed on the filtered signal, and finally the signal is rechecked for noise and artifacts in the frequency domain, again using NeuroSky's proprietary algorithms. Dr. Shlomo Wagner of the Sagol Department of Neurobiology at the University of Haifa, who undertook the study on emotions on different geo-locations influence learning and memory processes in the brain, explains: \"It turns out that different emotions cause the brain to work differently and on distinct frequencies.\" The objectives of capturing attention signal along with latitude and longtitude of location is to have an outlook about attentiveness of human on different geographical locations.
Designing a Geospatial System for Health Management Balbir Singh and Gvrk Acharyulu University of Hyderabad, India E-mail: [email protected], [email protected] ABSTRACT Health care is complex in terms of identification, creation, allocation and utilization of resources. Appropriate decision making is the key to success in terms of allocation and management of scarce resources. Resource management can be effectively handled by custom made tools like Decision Support Systems (DSSs). These DSSs can simplify the complex tasks like resource management which has both independent and dependent decision making components. Heuristics play a decisive role in terms of ability of a DSS in addressing coherent, integrated, and interdependent decision making. Human heuristic processes lack the ability to process high level and complex information in terms of magnitude as well as diversity. Health being extremely complex in nature relies heavily on informatics, DSS and data analytics to make relevant decisions. DSSs are built with inherent capability to consistently devise parameters to process chunks of information in an effective manner. The system is designed so as to provide accessibility to local users and administrators, registered medical practitioners, rural health departments, researchers and the general public with varied level of user and administrative rights. While administrators and technical users like medical practitioners and health departments are given complete user rights to view, edit, save and update changes, other user have varied level of access depending upon the information desired and purpose. The geospatial database primarily serves public departments. It also serves the users outside the purview of public departments for providing basic information and enabling them to make informed choices with limited accessibility to ensure security and protection. The geospatial database will serve the purpose of creating a unique database, community reporting, incident reporting like epidemics, health assistance and accountability, training and capacity building and analysis. The model will serve as an innovative approach towards health management in a systematic and quantitative manner which is accessible through internet. KEYWORDS: Health Management, Decision Support, Geospatial System, Assistance
Managing the Most Dreaded Infection Dysentery with Health Geo Spatial Website Shridhar T. Srinivasan IAS Rtd,1 Yogun Gandhi Raja,2 Janakiraman Radhika,2 Babu Doraismy,2 Ramakrishnan Venugopal Venkatachalam2 and Ghouse Mohamed Shaik2 1former CRA and relief Commissioner, Tamil Nadu State, India, E-mail: [email protected] 2Sri Venkateswara college of Engineering and Technology, Thirupachur, Thiruvallur, India E-mail: [email protected], [email protected], [email protected] [email protected], [email protected] ABSTRACT Dysentery is an infection associated with bacteria, viruses, parasitic worms or protozoa. It causes inflammation of the intestine leading to diarrhea with blood1. Some will have fever, abdominal pain and/or a feeling of incomplete defecation, especially of the colon. Frequent passage of feces with blood and/or mucus, associated with vomiting of blood in few cases. It is classified as gastroenteritis, a mechanism causing inflammatory disorder of the intestine. No vaccine is invented till date. It is sad to learn that Dysentery has modified history by taking away the legends like Akbar the Great, King John, King HenryV of England etc., when the victims were young or at peak of their carrier and prevented them to fulfill their dreams. The inability to provide clean water, lack of advanced knowledge in identifying the disease, poor sanitation and superstition (the belief in supernatural causality—that one event causes another without any natural process linking events—such as astrology, religion, omens, witchcraft, and prophecies, that contradicts natural science) were the cause for so many victims of Dysentery. Even in these modern days World Health organization estimates that shigellosis accounts for about 120 million cases of severe dysentery with blood and mucus in stools worldwide. Many take it lightly till the problem becomes severe and avoid medical assistance by self-medication. Dysentery has to be notified immediately to avoid infections to others. Preventive measures to identify hot spots causing unhealthy environment with the use of Geo spatial analysis to provide water and sanitation is the only solution to control the decease. Creating awareness to public to lead healthy life, manage for clean surface and ground water using Geo spatial web site will be an effective solution to eradicate dysentery. It is time to provide Geo intelligence to monitor the affected person, public with private house hold using Geo spatial data. Geo spatially linked health emergency services protect the affected. Here an attempt has been made to explain dysentery and use of Geo spatial Health infrastructure for efficient in Public Health management of 120 million population of India by providing better awareness in managing the health disasters like Dysentery and to build Digital Geo spatial India to fulfill our efforts to have Swachh Bharat Abhiyan (One step towards cleanliness) with the ongoing Geo spatial National Networking project implemented by Sri Venkateswara college of Engineering and Technology, Thirupachur Thiruvallur. KEYWORDS: Dysentery, Great monarchs victims, vaccine yet to be developed, Geo spatial networking, Swachh Bharat Abhiyan, awareness, prevention, health emergency management.
1. INTRODUCTION his infant son King Henry VI to access the Dysentery occurs throughout the world as a throne of France. Others notable victims potentially serious common disorder of the are Sir Francis Drake (c. 1540 – 27/01/1596), digestive tract. This gastrointestinal Akbar the Great of India (11/2/1556- disorders is one of the oldest known as early 7/10/1605), Fr.MarquetteS.J. (01/06/1637- as the Peloponnesian War in the fifth 18/05/1675) Natha niel Bacon (02/01/1605- century B.C,. Where large groups of human beings lived together in close quarters with 26/10/1676), Phan Đình Phùng, (1847 - poor sanitation aboard sailing vessels, in army camps, walled cities2, and other 21/01/1896). Brief details are given in Table places in the ancient world, Epidemics of 1. dysentery were frequent. Water, contaminated with the bacterium with 3. DYSENTRY KILLED SOLDIERS AND SAILORS number of species in the genera IN THOUSANDS AND ALTERED HISTORY Shigella and Salmonella with the most At the late 19th century, the 'bloody flux”, common being Shigella dysenteriae is killed more soldiers and sailors than responsible for Dysentery. The mechanism is enemies bullets. Typhus and dysentery an inflammatory disorder of the intestine. It decimated, Napoleon's, Grande Armée, in is caused by a number of infectious agents Russia. During the American Civil War, more ranging from viruses, bacteria, protozoa than 80,000 Union soldiers died of and parasitic worms, It may also result from dysentery. In the summer of chemical irritation of the intestines. As late 1942 ,during World War II “The Selarang as the 18th and 19th centuries AD, sailors Barracks Incident”, forced crowding of and soldiers were victims the \"bloody flux\" 17,000 Anglo-Australian prisoners-of- than from injuries received in battle. In 1897 war (POWs) by their Japanese captors in a bacillus (rod-shaped bacterium) was the areas around the barracks square for identified as the cause of one major type nearly five days with little water and no of dysentery which affected people in the sanitation. Even after this incident which less developed countries and travelers in caused Dysentery, the Prisoner Of War the modern world5 who visit these areas. refused to sign a pledge not to escape Most cases of dysentery occur in which ended with the capitulation of the immigrants from the developing countries Australian commanders due to the and in persons who live in inner-city housing spreading of dysentery among their men3. with inadequate sanitation. Other groups of people at increased risk of dysentery are 4. DYSENTERY - THE WORLD HEALTH military personnel stationed in developing ORGANIZATION countries, frequent travelers, children in The World Health Organization refer only to day care centers and people in nursing the two7 major types of dysentery viz homes. bacillary dysentery, and Amoebic dysentery (amoebiasis). When people in 2. VICTIMS OF DYSENTERY INCLUDE KINGS, industrialized nations have dysentery, signs COMMANDERS, RELIGIOUS LEADERS ETC., and symptoms tend to be mild many won't King John of England (24/12/1166 - even see their doctor, and the problem 19/12/1216) who replaced monarchy by resolves in a few days. If a doctor comes parliamentary system by sealing Magna across a case of dysentery, local authorities Carta, King Henry V (09/08/1387 – 31/08/ need to be told - it is a notifiable disease as 1422) of England, the victorious monarch at World Health Organization estimates Battle of Troy who tried to annex France, that shigellosis accounts for about 120 and married French Prince Caroline to million cases of severe dysentery with become Emperor of France were victims of blood and mucus in stools worldwide. The Dysentery. Dysentery had it’s last laugh in vast majority of cases occur in developing the case of King Henry V and taking away nations among children aged less than five his life at the age of 37 and paving way for years. Each year approximately 1,100,000 people die from Shigella infection globally.
Sixty percent of these deaths are among 4.2 Amoebic Dysentery (Amoebiasis) very young children. Amoebic dysentery (amoebiasis) is caused by Entamoeba histolytica. This is one type 4.1 Bacillary dysentery of amoeba, which is more common in the Bacillary dysentery is caused by genus tropics. An amoeba is a protozoan (single- Shigella, a bacterium, the most common celled) organism that constantly changes and violent form of dysentery, mostly in shape while others use the term in a warm parts of the world where sanitation is broader sense. Amoebiasis is an infection poor and large groups of people are caused by the amoeba Entamoeba crowded together6. The disease is spread histolytica.4 through the feces of carriers who have the bacteria in their intestines; some carriers may have diarrhea, but others may not. Figure 1: Shigella sonii Figure 2: Amoebic Dysentery Amoebiasis sometimes incorrectly refered Infection occurs after eating contaminated to infection with other amoebae, but strictly speaking it should be reserved for food or drinking polluted water. Touching a Entamoeba histolytica infection. Amebiasis is caused by Entamoeba histolytica (see contaminated object and then touching the image below), a protozoan that is found worldwide. The highest prevalence one's mouth can cause infection. Attacks of amebiasis is in developing countries where barriers between human feces and are always acute after the incubation food and water supplies are inadequate. period of a few days, with a high fever and Figure 3: Entamoeba histolytica Amebic liver abscess: is the most common sometimes shock and delirium. Bowel manifestation of invasive amebiasis, but other organs including pleura pulmonary, movements may be as many as 30 to 40 a day. An attack is usually over, within a few weeks, although in a child it may last longer. The Shigella organisms cause the diarrhea and dysentery associated with pain by invading the tissues that line the colon and secreting an entero toxin, or harmful protein that attacks the intestinal lining. The dysentery is vastly underreported.15,000 cases of shigellosis are reported each year even in the United States. USA maintains that the true number of annual cases may be as high as 450,000.5 About 85 percent of cases in the United States are caused by S. sonnei.
cardiac, cerebral, renal, genitourinary, 6. STUDY AREA IN THIRUVALLUR peritoneal, and cutaneous are involved. The study area at Thiruvallur from Kakkalur tank to Amebiasis primarily affects in developed Coovam river 9was formerly wet lands of paddy countries, migrants from and travelers to which were being converted in to housing plots endemic regions, men who have sex with from 1970 till date. Northern part is under men and immune suppressed or Kakkalur Pancatyath with narrow roads.8 institutionalized individuals. E histolytica is The housing development has taken place transmitted via ingestion of the cystic form in bits. The study area in the imagery is part (infective stage) of the protozoa. Cysts can of Peryakuppam. The other bits are Poonga be found in fecally contaminated soil, nagar, Ma Po Si Nagar, Old NGO colony, fertilizer or water or on the contaminated MGR Nagar, Indira Nagar etc. hands of food handlers. Excystation then occurs in the terminal ileum or colon, Figure 4: Toilet,septic Tank, Water well at resulting in trophozoites (invasive form). The closer level pollutes ground water trophozoites can penetrate and invade the The underground drainage work is under progress colonic mucosal barrier, leading to tissue in Areas covered by Thiruvallur Municipality which destruction, bloody diarrhea, and colitis will be linked to Sewage treatment plant near resembling inflammatory bowel disease. Cooum river at South Eastern corner. Kakkalur The trophozoites can spread Panchayath at north has only flood water street hematogenously via the portal circulation drains. No underground drainage. As the to the liver or even to more distant organs. underground drainage system even in Thiruvallur Municipality the resident of Thiruvallur Municipality 4.3 Viral dysentery and Kakkalur Panchayath the residents depends Acute diarrhea caused by viruses as known on Septic Tanks. Dysentery is caused by viral dysentery that causes Reiter's location septic tanks, water wells, toilets syndrome, a type of arthritis that develops very close as indicated in the sewage open later drains with stagnant sewage. 5. SYMPTOM Figure 5: Satellite Imagery of part of study Abdominal pain, fever and chills, nausea area near Jawaharlal Nehru Rd Thiruvallur and vomiting watery diarrhea, which can contain blood, mucus or pus painful passing of stools and fatigue intermittent constipation. In some cases, untreated dysentery can be life- threatening, especially if the infected person cannot replace lost fluids fast enough. E histolytica is capable of causing a spectrum of illnesses. Intestinal conditions resulting from E histolytica infection include Asymptomatic infection, Symptomatic noninvasive infection Acute proctocolitis (dysentery), fulminant colitis with perforation Toxic megacolon, Chronic nondysenteric colitis. Ameboma. Perianal ulceration. Extraintestinal conditions resulting from E histolytica are infection including the Liver abscess, Pleuro pulmonary disease, Peritonitis Pericarditis, Brain abscess and Genitourinary disease.
Figure 6: Houses, Road, Street, and rain Figure 8: Vegetation in study area growth water open drains (Red colour) along natural slope and drains These septic tanks are of 10000 lit capacity which are cleaned once in 4 to 5 months. The development has taken place in bits. This create pollution of ground water by solid and liquid waste which seep through The study area is part of Peryakuppam bit. the walls of septic tank which are 5 to 15 year old. The Population density is 1200 per The other bits are Poonga nagar, Ma Po Si sq km. Nagar, Old NGO colony MGR Nagar, Indira Figure 7: GIS layer of houses, septic tanks (dots) open drainage line (blue color) and Nagar, etc. The Chennai to Thiruvallur, Drinking water line study area The open drains and channels vegetation Jawahrarlal Nehru Road has commercial with pits and drains with stagnate water are a source to breed number bacteria complexes like GRT jewellary etc. High etc. Municipal area is with broad cement roads and open storm drainage lines with schools and multistoried housing stagnant sewage as there is no flow in the channels. The Kakkalur Pancatyath at complexes are in the southern part of study North has narrow roads. The empty plots have vegetation both in Thiruvallur area in Municipality limit. The growth of Municipal and Kakkalur Panchayth areas. plants fallow the natural run off channels. This area was under intensive paddy cultivation from Cooum river canal system which drained in Kakkalur Tank10. Now the irrigation channels are drains for sewerage and storm water. 8. GEO SPATIAL WEB SITE ON WATER QUALITY Geo spatial web site on Water quality, viruses, bacteria, protozoa and parasitic worms in soil and water is being created 1. Inspecting wells, other sources of drinki ng water,swimming pools for evidence of fecal contamination with GPS data and 3D aquifer GIS. 2. Health Education and Training i. Educating restaurant workers resident associations and other food handlers about proper methods of hand washing, food storage and food preparation, washing hands thoroughly with soap and hot running water for at least 10 seconds after
using the toilet or changing a baby's so the Public Health can be managed. It diaper, and before handling food. will assist in careful reporting by Medical ii. Educating teachers or workers in day Practitioners public health agencies to care centers and nursing homes investigate local outbreaks and prepare about the proper methods for prevention action plan by training public changing and cleaning soiled and health staff by adopting hygienic life diapers or bedding. style effectively by eliminating parasites iii. Impressing to follow Sanitary that cause dysentery. Measures in Health Web sites like Table 1: Kings, Commanders, Religious Clean bathrooms and toilets often; leaders etc. affected by Dysentery pay particular attention to toilet seats and taps. King John (24/12/1166 - 19/12/1216) of England Messages to house wives and restraints to avoid sharing towels or King John of England died of dysentery at Newark face washers etc, Castle who was King from 6 April 1199 until his death in To avoid raw vegetables from 1216. John lost the duchy of Normandy to King Philip II of endemic areas, as they may have France, following the battle of Bouvines which resulted been fertilized using human feces. in the collapse of most of the Angevin Empire and Boiling water or treat with iodine contributed to the subsequent growth in power of the tablets. Capetian dynasty during the 13th century. The baronial Avoid eating street foods especially in revolt at the end of John's reign led to the sealing of public places where others are the Magna Carta, a document sometimes considered sharing sauces in one container to be an early step in the evolution of the constitution Sedimentation and filtration of water of the United Kingdom. supplies are necessary to reduce the incidence of infection E.histolytica cysts King Henry V (09/08/1387 – 31/08/ 1422) which are usually resistant to chlorination. To adopt responsible King Henry V (09/08/1387 – 31/08/ 1422) was King of sewage disposal or treatment, to use England at the age of 35 in 1422. After fighting the Health GIS web site for the prevention of Welsh during the revolt of Owain Glyn Dwr and Percys E.histolytica infection on an endemic of Northumberland at the Battle of Shrewsbury he level. For updating attribute data by came into political conflict with his father, whose Health staff, voluntary organizations Red health was increasingly precarious from 1405. After his Cross, NSS etc Geo spatial attribute father's demise in 1413, Henry controlled the country data. and embarked on war with France in the ongoing Hundred Years' War (1337–1453) between the two. His Posting advisories for travelers successes at the Battle of Agincourt (1415) made him about outbreaks of dysentery and to come close to conquering France. other health risks in foreign countries After negotiation with Charles VI of France, the Treaty Health GIS web site. Travelers' Health of Troyes (1420) has recognized Henry V as regent and section of the website will be a good heir-apparent to the French throne, and was source to get up-to-date information. 9. CONCLUSION The project will provide GIS data to Medical practitioners to reduce disease11 caused by Shigella, Entamoeba histolytica and others. Geo spatial web site will provide data in managing Health and Environment issues. The Medical Practitioners and Paramedical workers in Govt and approved Private Hospitals will be trained to update the web site regularly
subsequently married to Charles's daughter, Catherine of Valois (1401–37). Following Henry V's sudden unexpected death from dysentery in France two years later, he was succeeded by his infant son, who reigned as Henry VI (1422–61, 1470–71). Sir Francis Drake, (c. 1540 – 27 /01/ 1596) Fr. Jacques Marquette S.J. (01/06/1637 – 18./05/`1675) Sir Francis Drake, vice admiral (c. 1540 – 27 /01/ 1596) was an English sea captain,, privateer, navigator, Fr. Jacques Marquette S.J. (01/06/1637 – slaver , and politician of the Elizabethan era. Drake 18./05/`1675), sometimes known as Père Marquette or carried out the second circum navigation of the world James (Jim) Marquette, was a French Jesuit missionary in a single expedition, from 1577 to 1580, and was the from Laon, Kingdom of France traveled westward in first to complete it as captain and leader of the the Grand Village of the Illinois near Starved Rock in expedition throughout the entire circumnavigation. USA.A bout of dysentery which he had contracted He died of Dysentery at the age of 36. Elizabeth I of during the Mississippi USA expedition sapped his England awarded Drake a knighthood in 1581. He was health. On the return trip to St. Ignace, USA he died second-in-command of the English fleet against the from dysentery at age 37 at Ludington, Michigan USA. Spanish Armada in 1588. He died of dysentery in January 1596[3] after unsuccessfully attacking San Phan Đình Phùng, (1847 - 1896) Juan, Puerto Rico. His exploits were legendary, making Phan Đình Phùng, (1847 - 1896) a died of dysentery in him a hero to the English but a pirate to the Spaniards Agadir Vietnamese revolutionary who led rebel armies to whom he was known as El Draque. King Philip II of against French colonial forces in Vietnam, died at the Spain was said to have offered a reward of 20,000 age of 49 because of dysentery as the French ducats, about £4 million (US$6.5M) by modern surrounded his forces on January 21, 1896. standards, for his life. Akbar the Great Mughal Emperor Nathaniel Bacon (02/01/1647 – 26/10/1676) (11/ 2/ 1556 – 27 /10/ 1605) Nathaniel Bacon (02/01/1647 – 26/10/1676) was a Akbar the Great Mughal Emperor (11/ 2/ 1556 – 27 colonist of the Virginia Colony, famous as the /10/ 1605) established a sprawling kingdom through instigator of Bacon's Rebellion of 1676, which military conquests, but is known for his policy of collapsed when died from dysentery at the age of 29. religious tolerance. In 1574 Akbar revised his tax system, separating revenue collection from military administration. Each subah, or governor, was responsible for maintaining order in his region, while a separate tax collector collected property taxes, rayathwari tax which is in vogue in even today in India.. Akbar the Great was affected by dysentery on 3 October 1605. He never recovered and believed to have died on or about 27 October 1605, after which his body was buried in a in mausoleum at Sikandra near Agra, in India.
Médaille à l'éphigie de Michel Vieuchange ed by Mark H. Beers, MD, and Robert Berkow 1904-1930 Smara 1er Novembre 1930 , MD. Whitehouse Station, NJ: MerckResearc h Laboratories, 2004. Michel Vieuchange (1904-1930) , the French 7. Burden of disease and cost-effectiveness estimates\". World Health Organi zation . April adventure, explorer ,the first European on his return 5, 2014a b Janovy, John; Schmidt, Gerald D.; Roberts, Larry S. (1996). Gerald D. Schmidt & from the \"forbidden city\" of Smara to visit the Larry S. Roberts. 8. ISPRS VIII/2: Health,Int Conference Melbourne abandoned ruins of the walled city of Smara and Australia Seo 2012, Monitoring Enviroinment with GIS for Part of Thiruvallur Town using writer who was born at Nevers France and died of Cartosat1 Stero PAN & Resourcesat LISS4 MSS Merged Data .Ghouse Shaik Mohamed, dysentery in Agadir at the age of 26 on 30 Nov 1930, Ramakrishnan Venugopal Venkata chalam, Mahendran .Ramamurthhy ,Radhika in the interior of the Sahara. Janakiraman Gummidipoondi, Murthy Ramillah BIBLOGRAPHY 9. ISPRS TC VIII Mid-Term Symposium 2014 Health 1. Foundations of parasitology. Dubuque, Iowa: SessionHyderabad, India. December 9-12, 2014. p512, Location based hazad Wm. C. Brown. ISBN 0-697-26071-2. vulnerabilty assessment, Assesing health and environment hazard using Gis to build 2. Brunette, Gary W. (ed), CDC Health Thiruvallur as a healthy smart city, Sindhu Venkat , Thiyagarajan Jayaraman Kantharaj Information for International Travel 2012. The , Gandhi Raja Yogan, Dr Kamal Natarajan,Dr Ghouse3 Mohamed Shaik Yellow Book, chapter 3. Oxford University 10 ISPR TC VIII Mid-Term Symposium 2014 Health Press. ISBN 978-0-19-976901-8 (2011). Content SessionHyderabad, India. December 9-12, 2014Environmental Risk factor analysis. Paper source: Centers for Disease Control and 518,Pilot Study to assess Environmental Risk Factors of Kakkalur Tank in Thiruvallur Town Prevention: National Center for Emerging to Develope as an enviroinmental park - J. Radhika , S. Devi, Retina sababthy, Dr N and Zoonotic Infectious Diseases (NCEZID), Kamal, Dr S Mohamed Ghouse Division of Global Migration and Quarantine 11 ISPRS Commision TC, WG VIII/2: Health Heath Care emergency Management 507 GIS for (DGMQ) Healthcare Emergency Management at Thiruvallur Taluk, Balasubramam, JanakI 3. Schnabel, Bastian. \"Drastic consequences of raman Radhika, ,Malathi, P. Rethina sababthy ,Dr. Ghouse Mohamed Shaik diarrhoeal disease\".Dziuban EJ, Liang JL, External links Craun GF, Hill V, Yu PA, et al. (22 December Water-related Diseases, Contaminants, and 2006). \"Surveillance for Waterborne Disease Injuries Listing of water-related diseases, contaminants and injuries with alphabetical and Outbreaks Associated with Recreational index, listing by type of disease (bacterial, parasitic, etc.) and listing by symptoms caused Water — United States, 2003–2004\". MMWR (diarrhea, skin rash, and many more) including links to other resources (CDC's Healthy Water Surveill Summ. 55 (12): 1–30.PMID 17183230. site)World Health Organization 4. Petrini, B. 2006 october \"Mycobacterium marinum: ubiquitous agent of water borne granulomatous skin infections\". Eur J Clin Microbiol Infect Dis. 25 (10): 609– 13. doi:10.1007/s10096-006-0201- PMID 17047903. 5. \"Infection with a Chlorophyllic Eukaryote after a Traumatic Freshwater Injury\". The New England Journal of Medicine. March 5, 2015 6..\"Enterobacteriaceae Infections.\" Section 13, C hapter 161 in The Merck Manual of Diagnosis andTherapy, edited by Mark H. Beers, MD, a nd Robert Berkow, MD. Whitehouse Station, NJ: MerckResearch Laboratories, 2004.\"Intesti nal Protozoa.\" Section 13, Chapter 161 in The Merck Manual of Diagnosis and Therapy,edit
Geo Spatial Data Base for Managing Health Issues in Private Public Participation Mode Thiyagarajan Jayaraman Kantharaj,1 Mohanram Govindarajulu,2,1 Damodharan Rangama Naidu3 , Muralidharan Balakrishnan,2 Tamilarasan4 and Ghouse Mohamed Shaik1 1Sri Venkateswara College of Engineering and Technology, Thirupachur, Thiruvallur Anna University, Thiruvallur-631203, India, E-mail: [email protected], [email protected] [email protected] 2Commissioner of Oath and Member Mediation and Reconciliation, India E-mail:[email protected] 3Bar Association 2013 &, 2014 & Senior Advocate, India E-mail:[email protected] 4Poonga nagar Welfare Association, India ABSTRACT The fast development of Thiruvallur Town which is headquarters of Thiruvallur District between Coouam and Kuasasthalai river in Tamil Nadu from 500 per sq km in1961 to 1200 per sq km in 2011, needs careful health care management. District Headquarters Hospital, Private Health Infrastructure, Private and Public Sector banks, Gold Jewelry business houses, super markets, Sri Veeraghavar Ancient Temple,. Thiruvallur Railway Station, Bus Terminus, educational institutes, Agri Business centres and creation of Infrastructures like roads and sewage treatment plant with underground drainage, brings Thousands floating population per day. This area has to be taken care to protect humanity from virus, bacteria, mosquitoes etc. Department of science and Technology Govt of India approved Health GIS project by networking 14 Research institutions in Hospitals, Universities and Colleges who are expert in their area. The Task of Creation of Ground Water quality GIS of the area between Cooum and Kakkalaur Tank in Thiruvallur is given to Sri Venkateswara college of Engineering and Technology Thirupachur, Thiruvallur to operate in Private Public Participation mode because the project needs lot of data from public and their willingness to share the environment, health data on house hold basis. The project was approved with the support letter of residents associations in the area to work with the institute. This land mark decision of the Department of Science and Technology to execute the project in Private Public Participation mode made it possible to get public involvement. They are providing water samples demographic and health data voluntarily with care. The PPP associations has advocates, presidents of welfare associations, retired Govt. officials, farmers etc. The merit and demerit of working in private and public participation mode on health issues is discussed in this paper. 1. INTRODUCTION Coouam and Kuasasthalai Rivers in wet In reality nearly half of the world’s lands from 500 per sq km in1951 to 1200 population is at risk with infections by per sq km in 2011 needs better health care bacteria, mosquitoes, virus etc. Even the management. The unified District court with residents of the developed nations like several benches started functioning from United States are not immune1. The insects, 2015 next to Collectorate. The Educational virus etc., kills hundreds every year than all institutes, District Headquarters Hospital and the wars in history by transmitting diarrhea, Health Infrastructure, Private and Public malaria, filariasis, jaundice, dengue, Sector banks, Gold Jewelry business encephalitis etc.2, The fast development of houses, super Market and Sri Veeraghavar Thiruvallur District headquarters between Ancient Temple, Agri Business,
Development of Infrastructure like road and 40ft width and having common and sewage treatment plants with borewell with over headed tank supplying underground drainage, Thiruvallur Station water to about 1500 households. Each and Bus Terminus brings Thousands of house has septic tank and bore well. floating population in a day3. The health care of managing both residents and Figure 2 The Geo Eye segment of part of floating population in this 15 sq km town is Poonga Nagar a major issue. In early 60’s these were wet lands, under Tank and river irrigation. Now this is Thiruvallur Municipality and Kakkalur Panchyath area. The residents and moving population need health care to protect them from virus, bacteria, mosquitoes etc. 2. DST -HEALTH NETWORKING PROJECT Department of science and Technology Govt of India approved a Health GIS project in networking mode linking 14 Research institutions in Hospitals, Universities, Colleges in India who are expert in their area. Figure 1: Tamil Nadu Thiruvallur Dist & Figure 3: The houses, streets and vegetation Thiruvallur Municipality and Kakkalur area from above image 3. STUDY AREA IN POONGA NAGAR 4. ENVIRONMENT AND HEALTH ISSUES The Task of Creation of Ground Water The flood water drains which carries waste quality GIS of the area between Cooum water by washing clothes, bath room and and Kakkalaur Tank in Thiruvallur is given to kitchens do not have good slope for free Sri Venkateswara college of Engineering Flow. The drains in Ma.Po.Si Nagar and and Technology Thirupachur, Thiruvallur to other areas are constructed on various work in Private Public Participation mode2. occasions based on availability of funds in The project needs lot of data from public schemes like Namakku Name project etc and their willingness to share the by the association and local housing environment, health on house hold basis. The houses and streets in Poonga nagar in figure 2 and 3 indicates no storm water street drains. The houses have the practice of storing water in pits or irrigating in gardens as the volume per house is less. The houses are in 40X 60, 45X80, 110X40 and 96X50 plots in Poonga nagar colony in Kakkalur panchayat. Poonga nagar welfare association assists panchayath in managing it3. The streets are of 20ft, 30ft
colonies. These drains have to be streets also as based on their experience in corrected for good slope to ensure free their street. flow if required re-laid for connecting to drains now constructed in Municipal areas 4. DRINKING WATER TO MA.PO. SI NAGAR to avoid stagnation of sewage water and This water tank is the source for drinking growth of mosquitoes. water lines to link street taps in Ma Po Si Nagar. The houses do not have separate water supply taps as the drinking water bore wells do not have the capacity to meet demand of all houses to have individual house taps. Figure 3: Waste water stagnates and a Figure 5a- 5b: Two views of big unused breeding ground for mosquitoes overhead tank near Kakkalur lake Each colony has overhead tank for about When this Big unused overhead tank starts 1000 households in Poonga nagar, Ma.po.si functioning it will meet the drinking water nagr. The road in Figure 3 at Ma.Po.Si demand Kakkalur and Thiruvallur Municipal Nagar colony in Kakkalur Panchayats has area so that each house hold may have flood water drains covered with cement taps in their houses. slabs near the housing colony welfare association office is as shown in figure 4. 5. MUNICIPAL STROM WATER DRAINS Figure 4: Water tank in Ma. Po. Si Nagar Figure 6: Storm water Drainage lines under and drain covered with cement slabs. construction in Thiruvallur Municipality area This is a good example of maintaining drainage system. If the well fare associations motivate each house owner to cover the drain with 8 or 9 slabs. Other streets will also have closed drains. The welfare associations can maintain other
The strom water drains constructed in 6. The associations will train the residents to Thiruvallur Municipality area is in the figure6, adopt hygienic practices to avoid health these type of drains are required in issues8. Kakkkalur Panchayath Area also to ensure uniform drainage system to link with 8. CONCLUSION common sewerage treatment constructed The involvement of welfare associations is by Municipality now. possible because of the support letter from associations requested by DST. The 6. ASSOCIATION WORKING IN PPP MODE Association are really good with active Poonga Nagar, Ma Po Si Nagar, NGO presidents with legal, academic, Govt. colony and Municipal colonies like Rajajai experience etc. It is possible to get health, Nagar, Devi Meenakhi Nagar were village and house data with Public developed in last 40 years. The association Participation. The project success is assured have supported the DST project on Health in PPP mode with active participation GIS by giving letter of support to SVCET to institute and associations. But we have to work in PPP mode. The associations are carefully screen the demands of assisting the project staff and students in associations as at sometimes it is beyond collecting water and soil sample, for the scope of projects executed by us. collection of Village and Municipal records, However we can fulfill their ambition with Health Data from Hospitals. The careful presentation to authorities. Associations wish to assist in formations of We have to appreciate the decision of this new projects like drainage, solid waste Department of Science and Technology to management, bio energy creating execute the project in Private Public awareness in using Health GIS and adopt Participation mode which has made it protective health measures. etc with the easier to get public involvement in assistance of various departments for providing water samples with care, executing in PPP mode.4. demographic and health data voluntarily by welfare associations. The associations 7. NEED OF ASSOCIATIONS have advocates and presidents of welfare 1. The drainage channels have to be associations, retired Govt. officials, farmers completed in all housing colonies by linking etc. The land mark decision of this Kakkalur and Thiruvallur Municipal areas.5 Department of Science and Technology to 2. The drainage channels should have have Private Public Participation9 has to be slope to ensure free flow of water without appreciated. stagnation. 3. Till such time the associations may take BIBLOGRAPHY steps to pump the water from drains using the service of government departments or 1.1998,The Roll Back Malaria (RBM) private agencies to avoid breeding of mosquitoes in drains.6 Partnership . RBM is the global 4. The associations will take effort to remove septic tanks and have framework for coordinated action underground drainage scheme as in Thiruvallur municipality area with Govt against malaria. support. 5. The grasses, biomass to be cleaned 2.1999 PATH Malaria Vaccine once in three months with government support or panchayat support with Initiative (MVI) , nonprofit organi schemes to convert the biomass as briquettes which can be used as clean zation global program for Appropriate source of energy in preparation of kababs in Star Hotels, This which will be a revenue Technology in Health (PATH)to for maintenance to associations8. accelerate the development of malaria vaccines and ensure their availability and accessibility in the developing world. 3. 2008 Zheng, J. Roehrich, J.K. and Lewis, M.A. The dynamics of contractual and relational governance: Evidence from long-term public-private procurement
arrangements. Journal of Purchasing 6. 2011.S.S. Raju. \"A successful Indian and Supply Management. 14(1): 43-54 model\". The Hindu Survey of Indian 4. 2008 Moszoro M., Gasiorowski P. 'Optimal Industry 2011. Capital Structure of Public-Private Partnerships', IMF Working Paper 1/2008. 7. 2011\"Status of PPP Projects as on July 31, Papers.ssrn.com (2008-01-25). Retrieved 2011\" (PDF). 8 March 2014. on 2011-11-20. 5. 2007\" PPP\". Department of Economic 8. 2013 Barlow, J., Roehrich, J.K. and Wright, Affairs, Ministry of Finance, Government S.. Europe observes Mixed Results from of India. Public-Private Partnerships for Building and Managing Health Care Facilities and Services. Health Affairs. 32(1):146-154 http: //www.ncbi.nlm.nih.gov/pubmed/2329728 2
Technical Session: 6 Health and Environment GIS In Planning, Implementation and Monitoring of National Health 73 Programme - National Leprosy Eradication Programme 74 Reetika Yadav and Anil Kumar 75 76 Animal Health Management and Intensive Livestock Production Analysis by using GIS and Remote Sensing 77 Ravi Kumar, N. Mohammed, Abhimanu and A.K. Kataria 78 Spatial Epidemiology and Prevalence of Mycobacterium avium Subspecies paratuberculosis Infection in Cattle Herds of Tamil Nadu Vinodh Kumar, O. R., Gunaseelan, Sinha, D. K. and Singh, B. R. Travel Time to Reach Health Facilities in Disadvantaged Regions: Evidence on the Supply And Demand Sides of the Health System using Network Analysis Lalitha Vadrevu Air pollution Exposure Assessment in Urban Slums of Mumbai Abhay Anand Need of Geo Spatial Analysis while Converting Wet Lands to Avoid It be a Breeding Ground for Mosquitoes – Study of Thiruvallur Town Yogan Gandhi Raja, Sindhu Maheshwaran, Edith Esther Edwin, Balasubramaniyan Mani and Ghouse Mohamed Shaik
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