Molecular Epidemiology of Escherichia coli isolates from Environmental, Food and Clinical Sources

In the present study diversity of E. coli in the water samples of Cochin estuary were studied for a period of 3 years ranging from January 2010- December 2012. The stations were selected based on the closeness to satellite townships and waste input. Two of the stations (Chitoor and Thevara) were fixed upstream, two in the central part of the estuary namely Bolgatty and Off Marine Science Jetty, and one at the Barmouth. Diversity was assessed in terms of serotypes, phylogenetic groups and genotypes. Two groups of seafood samples such as fish and shellfish collected from the Cochin estuary were used for isolation of E. coli. One hundred clinical E. coli isolates were collected from one public health centre, one hospital and five medical labs in and around Cochin City, Kerala. From our results it was clear that pathogen cycling is occurring through food, water and clinical sources. Pathogen cycling through food is very common and fish and shellfish that harbour these strains might pose potential health risk to consumer. Estuarine environment is a melting pot for various kinds of wastes, both organic and inorganic. Mixing up of waste water from various sources such as domestic, industries, hospitals and sewage released into these water bodies resulting in the co-existence of E. coli from various sources thus offering a conducive environment for horizontal gene transfer. Opportunistic pathogens might acquire genes for drug resistance and virulence turning them to potential pathogens. Prevalence of ExPEC in the Cochin estuary, pose threat to people who use this water for fishing and recreation. Food chain also plays an important role in the transit of virulence genes from the environments to the human. Antibiotic resistant E. coli are widespread in estuarine water, seafood and clinical samples, for reasons well known such as indiscriminate use of antibiotics in animal production systems, aquaculture and human medicine. Since the waste water from these sources entering the estuary provides selection pressure to drug resistant mutants in the environment. It is high time that the authorities concerned should put systems in place for monitoring and enforcement to curb such activities. Microbial contamination can limit people’s enjoyment of coastal waters for contact recreation or shellfish-gathering. E. coli can make people sick if they are present in high levels in water used for contact recreation or shellfish gathering. When feeding, shellfish can filter large volumes of seawater, so any microorganisms present in the water become accumulated and concentrated in the shellfish flesh. If E. coli contaminated shellfish are consumed the impact to human health includes gastroenteritis, urinary tract infections (UTIs), and bacteraemia. In conclusion, the high prevalence of various pathogenic serotypes and phylogenetic groups, multidrug-resistance, and virulence factor genes detected among E. coli isolates from stations close to Cochin city is a matter of concern, since there is a large reservoir of antibiotic resistance genes and virulence traits within the community, and that the resistance genes and plasmid-encoded genes for virulence were easily transferable to other strains. Given the severity of the clinical manifestations of the disease in humans and the inability and/or the potential risks of antibiotic administration for treatment, it appears that the most direct and effective measure towards prevention of STEC and ExPEC infections in humans and ensuring public health may be considered as a priority.

Solid Waste Management: A Case Study of Arppukara Grama Panchayat Of Kottayam District, Kerala (India)

The rising pressure of Population, together with the constantly changing technologies, and development perspectives, contribute to the ever increasing volumes of wastes in different forms. The solid and liquid wastes generated in the urban areas were considered a burden to the society, and hazardous to the environment. The fact is that the growth of consumerist culture and aimless throwing of refuse by the people created the outbreak of environmental pollution. Unhygienic environment and solid waste accumulation coincided with mosquito breeding which causes, the spread of most epidemics. The rationale behind most of the diseases is the unhygienic pattern followed by the people both in rural and urban areas. As an environmental package, the disposal of solid waste from different sources, such as house holds markets, commercial areas, slaughter houses, hospitals and industries, therefore assumed crucial importance. So as a part of the theory and practice, a study on the area, solid waste management of Arppukara Grama Panchayat of Kottayam district is taken into consideration. The study conducted here proposes, to examine the quality and quantity of the solid waste generated in the panchayat and also it's impact on the existing social, economical, environmental and ecological systems

Efficiency in Delivering Obstetric Care-A Comparison of Public and Private Hospitals in Ernakulam District

Department of Applied Economics, Cochin University of Science and Technology

Cost accountancy and cost control in hospitals

It is a fact that there now exists a sound framework of accounting theory to ascertain the working results and the investment status of hospitals. Yet, there is no system of accounting in practice to conduct its activities with utmost efficiency. No attempts have hitherto been made for the continuous improvement in the servics rendered by hospitals. Personal investments in hospitals have made the interaction of business to some extent.Planning, decision making and control assume increasing importance as hospitals grow in size and complexity. Moreover, wise and effective utilisation of resources should be ensured. The importance of cost cannot be overlooked in this context. Cost is the most effective factor in the determination of the prices of hospital services rendered. The important managerial functions have to rely heavily on accurate and timely cost information. More people can be provided with services if no services cost more than what is a must to provide the necessary level of care. The price paid for high cost technology for a few is no technology at all for the many. Hence no pains must be spared in ascertaining, presenting, controlling and reducing costs. An effective system of Cost Accountancy and Cost Control is imperative for the survival of hospitals in the intensely competitive conditions of today. The valuable objective of "better patient care" can be attained only if the management can make use of the various tools and techniques to ascertain, control and reduce each item of cost in hospitals. Constant efforts must be made by the management to continuously improve their services and bring down costs and prices of all hospital services. Cost Accountancy has made its impresssive impact on almost all the spheres of human activities. It is high time a comprehensive Cost Accountancy and Cost Control system be implemented in hospitals. The problem under study thus is the designing of a sound and full-fledged Cost Accountancy and Cost Control system that suits the requirements of hospitals. It is for the first time in India during the evolution of Cost Accountancy that a comprehensive cost system is tried in hospitals.