BackgroundParticipation of private practitioners in routine disease surveillance in India is minimal despite the fact that they account for over 70% of the primary healthcare provision. We aimed to investigate the knowledge, attitudes, and practices of private practitioners in the city of Pune toward disease surveillance. Our goal was to identify what barriers and facilitators determine their participation in current and future surveillance efforts.DesignA questionnaire-based survey was conducted among 258 practitioners (response rate 86%). Data were processed using SPSS™ Inc., Chicago, IL, USA, version 17.0.1.ResultsKnowledge regarding surveillance, although limited, was better among allopathy practitioners. Surveillance practices did not differ significantly between allopathy and alternate medicine practitioners. Multivariable logistic regression suggested practicing allopathy [odds ratio (OR) 3.125, 95% confidence interval (CI) 1.234–7.915, p=0.016] and availability of a computer (OR 3.670, 95% CI 1.237–10.889, p=0.019) as significant determinants and the presence of a laboratory (OR 3.792, 95% CI 0.998–14.557, p=0.052) as a marginal determinant of the practitioner's willingness to participate in routine disease surveillance systems. Lack of time (137, 55%) was identified as the main barrier at the individual level alongside inadequately trained subordinate staff (14, 6%). Main extrinsic barriers included lack of cooperation between government and the private sector (27, 11%) and legal issues involved in reporting data (15, 6%). There was a general agreement among respondents (239, 94%) that current surveillance efforts need strengthening. Over a third suggested that availability of detailed information and training about surveillance processes (70, 33%) would facilitate reporting.ConclusionsThe high response rate and the practitioners’ willingness to participate in a proposed pilot non-communicable disease surveillance system indicate that there is a general interest from the private sector in cooperating. Keeping reporting systems simple, preferably in electronic formats that minimize infrastructure and time requirements on behalf of the private practitioners, will go a long way in consolidating disease surveillance efforts in the state. Organizing training sessions, providing timely feedback, and awarding continuing medical education points for routine data reporting seem feasible options and should be piloted.

BackgroundDespite the rising impact of non-communicable diseases (NCDs) on public health in India, lack of quality data and routine surveillance hampers the planning process for NCD prevention and control. Current surveillance programs focus largely on communicable diseases and do not adequately include the private healthcare sector as a major source of care in cities.ObjectiveThe objective of the study was to conceptualize, implement, and evaluate a prototype for an urban NCD sentinel surveillance system among private healthcare practitioners providing primary care in Pune, India.DesignWe mapped all private healthcare providers in three selected areas of the city, conducted a knowledge, attitude, and practice survey with regard to surveillance among 258 consenting practitioners, and assessed their willingness to participate in a routine NCD surveillance system. In total, 127 practitioners agreed and were included in a 6-month surveillance study. Data on first-time diagnoses of 10 selected NCDs alongside basic demographic and socioeconomic patient information were collected onsite on a monthly basis using a paper-based register. Descriptive and regression analyses were performed.ResultsIn total, 1,532 incident cases were recorded that mainly included hypertension (n=622, 41%) and diabetes (n=460, 30%). Dropout rate was 10% (n=13). The monthly reporting consistency was quite constant, with the majority (n=63, 50%) submitting 1–10 cases in 6 months. Average number of submitted cases was highest among allopathic practitioners (17.4). A majority of the participants (n=104, 91%) agreed that the surveillance design could be scaled up to cover the entire city.ConclusionsThe study indicates that private primary healthcare providers (allopathic and alternate medicine practitioners) play an important role in the diagnosis and treatment of NCDs and can be involved in NCD surveillance, if certain barriers are addressed. Main barriers observed were lack of regulation of the private sector, cross-practices among different systems of medicine, limited clinic infrastructure, and knowledge gaps about disease surveillance. We suggest a voluntary augmented sentinel NCD surveillance system including public and private healthcare facilities at all levels of care.

The design and implementation of autonomous and semi-autonomous robots for accomplishment of different types of domestic tasks and goals, from comparatively simple work such as cleaning to complicated tasks such as interacting with humans to provide companionship, is one of the major thrust areas for the modern age. In the present paper, an effort has been made by the group members to perform a comparatively simple task in a sophisticated manner, through the design of a navigation algorithm for a smart floor cleaner robot. An algorithm for effective cleaning of the floor has been developed through modification of the well-known algorithm by Dijkstra, to allow for minimal backtracking to complement the hill-climbing approach, enhancing the energy efficiency of the system by optimization of robotic motion.

Amelogenesis imperfecta (AI) comprises a complicated group of conditions, involving a structural defect of the tooth enamel, owing to certain genetic disturbances. It is expressed as an autosomal dominant, autosomal recessive or X-linked recessive trait. The structural pattern and clinical appearances of all the teeth, including those in the deciduous as well as the permanent dentition, are affected. It may be differentiated into three main divisions such as hypoplastic, hypocalcific and hypomaturative patterns. Eruption of tooth refers to a complex coordinated physiological process characterized by the movement of a tooth from its initial developmental position within the jaws to its final functional position in the occlusal plane, dictated crucially by dental follicle, bony remodeling metabolic alteration and molecular determinants. Alteration involving any one of the factors might cause hindrances. Herein, we report two cases with AI associated with noneruption.

Background: Piped water systems are considered to be the gold standard for drinking water according to the Joint Water Monitoring Study. However, poor maintenance of distribution pipes, intermittency of water supply, and sewage water intrusion have contributed to a number of water-borne disease episodes in developed and developing countries. Methods: This study investigated the risk burden related to drinking water and sanitation in population clusters of Pune, western India that are being served by a piped distribution system through a cross-sectional survey. Two-stage stratified convenience sampling was carried out. The city was divided into administrative wards of which the city center, the neo-urban and the peri-urban settlement were selected. In the second step a higher (HSG) and a lower socioeconomic group (LSG) were selected from each of the three studied wards. A questionnaire including close-ended items was used to conduct the survey. Results: In 2711 individuals studied, risk burden related to drinking water and sanitation was found to be higher in the LSG; 60% (677 of 1121), 70% (1029 of 1473) , 74% (1325 of 1791) from the LSGs did not have a private water tap and continuous water supply, and did not treat the water at the household level, respectively. 98% (1403 of 1426) had neither a private water tap nor a private sanitary facility. The socioeconomic difference was significant (p<0.0001). 51 (3.5%) individuals from the LSGs and 42 (3.49%) ones from HSGs reported having suffered from severe diarrhea in the recall period of 2 years. Although the number of disease cases was lower than the overall risk burden, the potential of the latter to cause a disease outbreak cannot be eliminated. Conclusion: The study highlights that piped drinking water system which is considered as a safe source can become a source of pathogenic microorganisms if not properly maintained. A holistic approach to risk assessment, i.e., from the catchment and its source water to the consumer, is required.