Methods: A cross-sectional community-based survey was carried out during the high malaria transmission season of 2006 in Boudh district. Respondents (n = 300) who Batimastat had fever with chills within two weeks prior to the day of data collection were selected through a multi-stage sampling and interviewed with a pre-tested and structured interview schedule. Malaria treatment providers (n = 23) were interviewed in the district to gather their insights on factors associated with prompt and effective treatment through a semi-structured and open-ended interview guideline.

Results: Majority

of respondents (n = 281) sought some sort of treatment e. g. government health facility (35.7%), less qualified providers (31.3%), and community level health workers and volunteers (24.3%). The single most common reason (66.9%) for choosing a provider was proximity. Over a half (55.7%) sought treatment from appropriate providers within 48 hours of onset of symptoms. Respondents under five years (OR 2.00, 95% CI 0.84-4.80, P = 0.012), belonging to scheduled tribe community (OR 2.13, 95% CI 1.11-4.07, P = 0.022) and visiting a provider more than five kilometers (OR 2.04, 95% CI 1.09-3.83, P = 0.026) were more likely to have delayed or inappropriate treatment. Interviews with the providers indicated that patients’ lack of trust in community volunteers

providing treatment led to inappropriate treatment-seeking from the less qualified providers. The reasons for the lack of trust included Nutlin-3 concentration drug side effects, suspicions about drug quality, stock-outs of drugs Selinexor mouse and inappropriate

attitude of the provider.

Conclusion: Large-scale involvement of less qualified providers is suggested in the malaria control programme as volunteers after appropriate capacity development since the community has more trust in them. This should be supported by uninterrupted supply of drugs to the community volunteers, and involvement of the community-based organizations and volunteers in the planning, implementation, and monitoring of malaria control services. There is also a need for continuous and rigorous impact evaluations of the program to make necessary modifications, scale up and to prevent drug resistance.”
“To study the normal ranges of sleep-wake cycles in normal fetuses.

A total of 600 fetal heart rate (FHR) tracings were studied from uncomplicated singleton pregnancies at a gestational age between 30 and 40 weeks with a 1-h recording. Two obstetricians interpreted all the FHR recordings independently.

The mean baseline FHR was 141.6 (7.6) beats/min. The median relative percentage time spent in a quiet state was 26% (0-88.6). The median duration of time spent in a quiet state was 15.7 min (0-53.2) within a 1-h recording. Both quiet and active states were established in 84% of cases.