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Hypoxia-ischemia (HI) can result in permanent life-long injuries such as motor and cognitive deficits. In response to cellular stressors such as hypoxia, tumor suppressor protein p53 is activated, potently initiating apoptosis and promoting Bax-dependent mitochondrial outer membrane permeabilization. The aim of this study was to investigate the effect of Trp53 genetic inhibition on injury development in the immature brain following HI. HI (50 min or 60 min) was induced at postnatal day 9 (PND9) in Trp53 heterozygote (het) and wild type (WT) mice. Utilizing Cre-LoxP technology, CaMK2α-Cre mice were bred with Trp53-Lox mice, resulting in knockdown of Trp53 in CaMK2α neurons. HI was induced at PND12 (50 min) and PND28 (40 min). Extent of brain injury was assessed 7 days following HI. Following 50 min HI at PND9, Trp53 het mice showed protection in the posterior hippocampus and thalamus. No difference was seen between WT or Trp53 het mice following a severe, 60 min HI. Cre-Lox mice that were subjected to HI at PND12 showed no difference in injury, however we determined that neuronal specific CaMK2α-Cre recombinase activity was strongly expressed by PND28. Concomitantly, Trp53 was reduced at 6 weeks of age in KO-Lox Trp53 mice. Cre-Lox mice subjected to HI at PND28 showed no significant difference in brain injury. These data suggest that p53 has a limited contribution to the development of injury in the immature/juvenile brain following HI. Further studies are required to determine the effect of p53 on downstream targets.

We studied the urinary abnormalities and acute kidney injury (AKI) as per RIFLE criteria in scrub typhus. A prospective case record-based study of scrub typhus was carried out from January 2009 to December 2010 in a tertiary hospital in South India. Patients were followed up until renal recovery or for at least 3 months after discharge. Univariate, chi-squared tests and multivariate logistic regression analyses were performed to identify the predictors of AKI. Scrub typhus was diagnosed in 259 patients. Urinary abnormalities were seen in 147 patients (56.7 %) with 60 patients (23.2 %) having AKI. All AKI patients had urinary abnormalities and 17 (28.3 %) were oliguric. Applying RIFLE (risk, injury, failure, loss, end-stage kidney disease) criteria, R, I, F were present in 23 (38.33 %), 13 (21.67 %), and 24 patients (40 %), respectively. Creatine phosphokinase (CPK) was raised in 33 patients (55 %) and hemodialysis was required in 6 patients (10 %). The case fatality rate in this study was 2 out of 259 (0.77 %), both having AKI and others recovering clinically. Significant predictors of AKI were tachycardia [odds ratio (OR) 2.28], breathlessness (OR 2.281), intensive care requirement (OR 2.43), mechanical ventilation (OR 3.33), thrombocytopenia (OR 2.90) and CPK >80 U/L (OR 1.76) by univariate analysis and intensive care requirement (adjusted OR 2.89) and thrombocytopenia (AOR 2.28) by multivariable logistic regression. Scrub typhus should be part of the differential diagnosis of acute febrile illness with AKI. AKI in scrub typhus is usually mild, non-oliguric, and renal recovery occurs in most patients. Rhabdomyolysis may be contributory to AKI. Thrombocytopenia and intensive care requirement are significant predictors of AKI in scrub typhus.

Rising number of infertile males in India provokes the need of evidence-based comprehensive formula addressing unattended causes of male infertility. There is an innovative product*, a combikit available in Indian market, containing 30 tablets of antioxidant, multivitamin, amino acid and mineral tablets, with documented evidence on ingredients in treatment of male infertility, and 25 tablets of clomiphene citrate which is a timetested drug in treatment of male infertility (in particular oligospermia and/or asthenospermia). In order to assess efficacy of the product in Indian infertile male patients, we undertook phase IV multicentric clinical study, at 18 centers across India in 100 patients. Very high couple pregnancy rate of 53% was reported. As first line treatment of male infertility (in particular oligospermia and/or asthenospermia), the use of this innovative product therefore holds a strong promise. How to cite this article Amin J, Mishra SK, Dutta AK, Kunwar K, Shinde VG, Chauhan A, Sud S, Maurya R, Nepal N, Sarode P, Biswas KP, Mazumder GP, Chitrabanshi M, Shibe S, Shukla R, Trivedi N, Dayal M, Sortey D, Shukla S, Gawade B. Indian Clinical Experience on Innovative Product in Treatment of Male Infertility. J South Asian Feder Obst Gynae 2013;5(2):76-79.

Rotavirus is the leading cause of severe and dehydrating diarrhea in children aged under 5 years. We undertook this hospital-based surveillance study to examine the possible relationship between the severity of diarrhea and the various G-group rotaviruses circulating in India. Stool samples (n = 2,051) were systematically collected from 4,711 children aged

Background: Iodine deficiency is one of the most prevalent micronutrient deficiencies globally. Women in reproductive age group are vulnerable to develop iodine deficiency as there is an increase in demand for iodine, especially during pregnancy. Objectives: The objective is to assess the prevalence of goiter and its association with iodine status and salt usage practices among the women of reproductive age group. Methods: A community-based cross-sectional study was conducted from August 2015 to July 2017 among 1500 women of reproductive age group in five villages of Udupi Taluk. Stratified sampling design and proportion to population size of the reproductive age women in the study area was used to select the study participants. A pretested semi-structured questionnaire was used for data collection. Goiter was assessed clinically and graded as per the recommended criteria of the WHO. Salt samples from every household were collected for iodine estimation. Blood and urine samples were collected from subsample to estimate thyroid-stimulating hormone levels and urinary iodine excretion levels, respectively. Results: The overall prevalence of goiter was 13% with 11.5% being Grade 1 and 1.5% being Grade 2. No significant association of goiter with urinary iodine, salt iodine levels, and salt usage practices was found. Conclusions: Median urinary iodine among the women with goiter indicates iodine sufficiency and no significant difference observed in urinary iodine levels between women with and without goiter.

Background: Unfavorable attitude towards mental health disorders are prevalent in the general population.Since teachers are considered as key resources in the promotion of adolescent’s mental health, assessing their attitudes and beliefs are crucial.Materials and Method: A descriptive cross-sectional study was conducted in Udupi Taluk. A semistructured questionnaire was used to assess their perceptions of regarding mental health disorders. A total of 93 high school teachers were included in the preliminary study.Results: Out of 93 respondents, 45(48.4%) were in the age group 30-39 years and 38 (40.9%) of the respondents had 5-9 years’ teaching experience. About (58.1%) of the respondents indicated that mental health problems were not a real medical illness and 80.6% of the respondents stated that mental health disorders were signs of personal weaknesses. About 53.8% cited that people with mental health problems were not dangerous to others and 55.9% of them reported that it is easier to give advice to someone else to seek help than for themselves in relation to mental health.Conclusion: Preliminary findings indicated that teachers were willing to participate in the study. There is a need to provide interventions to teachers to develop a positive attitude towards mental illnesses, which is very much essential in the promotion of mental health of the adolescents

Background: Hypertension in children and adolescents has become increasingly common. We sought to study the prevalence of hypertension among apparently healthy school children in Udupi Taluk, a rapidly developing coastal region in Karnataka in South India and correlate high blood pressures with age, gender and BMI. Method :A total of 2067 students (1055 boys and 1012 girls) between the ages of 5 – 16 years from rural schools in Udupi taluk were studied as part of school health services. Height (in cm) and weight (in kg) were recorded along with Blood Pressure measurements using the auscultatory method. Blood pressure was measured twice among children who were found to have a high reading (more than the 95th percentile) the first time. Using WHO charts for BMI for boys and girls, prevalence of overweight and obese children was determined. The evaluation of hypertension was based on the Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents. Results: Overall prevalence of hypertension in children was 2.2%. Prevalence of hypertension in female children was 2.4% and in males it was 2.1%. The proportion of hypertensives was found to the maximum in the 14-16 year age group. The prevalence of obesity among girls and boys was found to be 1.5% and 1.1% respectively. The prevalence of systolichypertension was found to be significantly higher (P=0.041) in obese children (12.5%) as compared to that in underweight children (1.4%). Conclusion: We found that higher BMI was associated with higher blood pressures. The results suggest that the prevalence of hypertension is mainly in the adolescent age group; therefore targeted screening in this group would be beneficial.

Background: Among adolescents, girls are particularly vulnerable not only because they are more likely to be coerced for unprotected sex but also because they are more susceptible biologically to sexually transmitted diseases (STDs), including HIV infection. This study was carried out to determine the effectiveness of an educational intervention programme aimed at girls focusing on knowledge of and attitude to HIV/AIDS. Method :An educational intervention study was carried out among 791 rural girls (16-19 years) randomly selected using stratified cluster sampling from coastal villages in Udupi Taluk, Karnataka, Southern India. They were educated regarding HIV/AIDS and their awareness levels were evaluated immediately and one month following intervention. Results: Around 35-50% of the girls had misconceptions regarding the modes of transmission which significantly reduced to about 8 % after intervention (95% CI of difference inproportion = (9.2, 17.9); p

Background: Menstrual abnormalities are a major gynaecological problem faced by adolescent girls leading to morbidity that may have an adverse effect on their school attendance. The objective of the study was to determine prevalence of menstrual disorders in girls aged 10-19 years and to study their treatment-seeking behaviour.Methods: We conducted a cross-sectional study on 592 girls in the age group of 10 to 19 years attending schools in Pune city during January 2016 to December 2016. Permission was sought from school authorities. Girls 10-17 years were included after obtaining parental consent. For 18 and 19 year olds, informed consent was taken from the girls themselves. Demographic information, height, weight and characteristics of menstrual period were noted.Results: Majority girls (36%) were in age group 12.1-14 years. Most prevalent menstrual disorder was painful menses reported by 70% of girls, followed by heavy menstrual bleeding (46%) and cycle irregularity (22%). All menstrual disorders were most commonly prevalent in the age group of 14.1 to 16 years. Proportion of girls visiting a doctor and taking medications for painful menses was 26.7% and 16.5% respectively, for heavy menstrual bleeding was 25.7% and 16.5% respectively and for cycle irregularity was 33% and 16.5% respectively. No association was found between mother’s education and treatment seeking behaviour for menstrual disorders.Conclusions: In spite of high prevalence of menstrual disorders, only a minority of the adolescents seek expert advice. This underscores the need for creating awareness among girls, mothers and teachers and developing a screening tool to identify girls who could benefit by further investigation and follow-up.

Background The prevalence of underweight children in India is among the highest in the world, and is nearly double that of Sub- Saharan Africa. The effect of malnutrition is high morbidit and mortality among young children. The objective of this study was to determine the nutritional status of children aged between 3-6 years registered in government sponsored maternal and child care Anganwadi centres in India. Method A cross-sectional study was conducted in 35 centres in 11 villages situated in the field practice area of Community Medicine Department of a Medical College situated in Southern India. Results Of the 585 children in the study, 46.5% of the children were aged between 36 to 48 months. Assessment of nutritional status using the ICDS growth chart revealed malnourishment to be present among 189 (32.3%) children, of whom 166 children were grade I malnourished and 23 children were grade II malnourished. Proportionally girls (46.2%) were more malnourished than boys (33.6%). No significant association was found between the nutritional status of children and their duration of stay in an Anganwadi centre (p-value=0.56).Conclusion The findings of this study indicate that malnutrition is still an important problem even among children attending Anganwadis. Further improvements in functioning of Integrated Child Development Services need to be made in order to address the problem of malnutrition

Background: The ubiquitous use of electronic health records (EHRs) during medical office visits using a computer monitor and keyboard can be distracting and can disrupt patient-health care provider (HCP) nonverbal eye contact cues, which are integral to effective communication. Provider use of a remote medical scribe with face-mounted technology (FMT), such as Google Glass, may preserve patient-HCP communication dynamics in health care settings by allowing providers to maintain direct eye contact with their patients while still having access to the patient’s relevant EHR information. The medical scribe is able to chart patient encounters in real-time working in an offsite location, document the visit directly into EHR, and free HCP to focus only on the patient. Objective: The purpose of this study was to examine patient perceptions of their interactions with an HCP who used FMT with a remote medical scribe during office visits. This includes an examination of any association between patient privacy and trust in their HCP when FMT is used in the medical office setting. Methods: For this descriptive, cross-sectional study, a convenience sample of patients was recruited from an outpatient dermatology clinic in Northern California. Participants provided demographic data and completed a 12-item questionnaire to assess their familiarity, comfort, privacy, and perceptions following routine office visits with an HCP where FMT was used to document the clinical encounter. Data were analyzed using appropriate descriptive and inferential statistics. Results: Over half of the 170 study participants were female (102/170, 59.4%), 60.0% were Caucasian (102/170), 24.1% were Asian (41/170), and 88.8% were college-educated (151/170). Age ranged between 18 and 90 years (mean 50.5, SD 17.4). The majority of participants (118/170, 69.4%) were familiar with FMT, not concerned with privacy issues (132/170, 77.6%), and stated that the use of FMT did not affect their trust in their HCP (139/170, 81.8%). Moreover, participants comfortable with the use of FMT were less likely to be concerned about privacy (P

Background: Change in socio-economic status and various health problems adversely affect an individual′s way of life during old age. Objectives: To study the health and social problems of the elderly and their attitude towards life. Materials and Methods : Descriptive study carried out in the Field practice area of the Department of Community Medicine in South India. A total of 213 elderly patients (60 years old and above) who attended the outreach clinics were interviewed using a pre-tested schedule. Findings were described in terms of proportions and percentages to study the socio-economic status of the samples and its correlation to social problems. Results: Around 73% of the patients belonged to the age group of 60-69 years old. Nearly half of the respondents were illiterate. Around 48% felt they were not happy in life. A majority of them had health problems such as hypertension followed by arthritis, diabetes, asthma, cataract, and anemia. About 68% of the patients said that the attitude of people towards the elderly was that of neglect. Conclusions: The results of the study showed that there is a need for geriatric counseling centers that can take care of their physical and psychological needs. The stringent rules for eligibility to social security schemes should be made more flexible to cover a larger population.

Background Several reports of chloroquine treatment failure and resistance in Plasmodium vivax malaria from Southeast Asian countries have been published. Present study was undertaken to assess the efficacy of chloroquine-primaquine (CQ-PQ) combined regimen for the treatment of P. vivax malaria patients who were catered by the selected primary health centres (PHCs) of Udupi taluk, Udupi district, Karnataka, India. Method Five PHCs were selected within Udupi taluk based on probability proportional to size. In-vivo therapeutic efficacy assessment of CQ (1500 mg over three days) plus PQ (210 mg over 14 days) regimen was carried out in accordance with the World Health Organization’s protocol of 28 days follow-up among microscopically diagnosed monoinfection P. vivax cohort. Results In total, 161 participants were recruited in the study of which, 155 (96.3%) participants completed till day 28 follow-up, fully complied with the treatment regimen and showed adequate clinical and parasitological response. Loss to follow up was noted with 5 (3.1%) participants and non-compliance with treatment regimen occurred with one participant (0.6%). Glucose-6-phosphate dehydrogenase deficiency (G6PDd

In India it is taboo to discuss sexual and reproductive health (RH) issues, especially with adolescent boys. Minimal research has been done in India to address the adolescent mindset of boys. Our aim was to study the unaddressed issues among boys and to highlight their perspectives regarding RH. Methods: A qualitative study design-using focus group discussions (FGD) in a rural-urban setting in South India was conducted. A convenient sample of 60 boys aged 16–19 years participated in six FGD and 10 boys had participated in in-depth interviews. Results: The study revealed that a cordial environment both at home and school were primary needs. Peer pressure and media instigated adolescents to get involved in risky behaviour and substance use. “Pornography”, “wrong myths about RH”, “substance use”, and “sexual attractions” were the primary unaddressed issues of boys. Participants had poor awareness about RH services. Conclusion: RH services are inadequate and proper infrastructure is required for providing these services to adolescent boys.

Background: Adolescence is a tumultuous period of hormonal and psychological transitions ranging from 10 to 19 years (WHO). This growth phase is usually accompanied by stressors. Very few studies have reported the prevalence of stress levels among adolescent boys. Our aim was to assess the prevalence and determinants of stress and its tolerance levels among high school boys. Methods: A cross sectional study design was selected for this purpose. A standardized self reported questionnaire was administered to 1153 high school boys. A score of 130 and more was used to classify the participants as stressed. Results: The prevalence of stress and its tolerance levels was found to be 55% and 33.7%, respectively. Also correlations suggest that parental education and occupational status play a significant role in adolescent stress. Together, these findings suggest necessitating an intervention to counter the same. Conclusion: The proportion of stressed adolescent boys (55.5%) reported to have poor stress tolerance (41%). Studies addressing stress among high school adolescents remain unexplored. The basic determinants of stress are not researched upon these age groups. Our study reports the prevalence of stress to be 55% among high school boys. This could be the fundamental basis of designing suitable stress management programs for adolescents that could reduce their stress levels.

442 pre-ART, HIV-infected adults were randomized to peer support consisting of structured home visits to promote clinic attendance and preventive care intervention use or standard of care. At baseline, 62 % reported previously visiting an HIV clinic, 45 % reported taking cotrimoxazole prophylaxis, and 31 % were "care-naive" (no previous clinic visit and not on cotrimoxazole). After 1 year, intervention participants were more likely to report being in care (92 vs 84 %; PRR 1.09, p = 0.039), on cotrimoxazole (89 vs 81 %; PRR 1.10, p = 0.047), and safe water vessel adherence (23 vs 14 %; PRR 1.64, p = 0.024). The effect was observed only among care-naive participants (n = 139) with 83 % intervention versus 56 % controls reporting being in HIV care (PRR 1.47, p = 0.006), 78 versus 58 % on cotrimoxazole (PRR 1.35, p = 0.04), and 20 versus 4 % safe water vessel adherence (PRR 5.78, p = 0.017). Peer support may be an effective intervention to facilitate pre-ART care compliance in this important population.

Background: Early life socioeconomic disadvantage could affect adult health directly or indirectly. To the best of our knowledge, there are no studies of the direct effect of early life socioeconomic conditions on oral cancer occurrence in adult life. Methods: We conducted a multicenter, hospital-based, case-control study in India between 2011 and 2012 on 180 histopathologically confirmed incident oral and/or oropharyngeal cancer cases, aged 18 years or more, and 272 controls that included hospital visitors, who were not diagnosed with any cancer in the same hospitals. Life-course data were collected on socioeconomic conditions, risk factors, and parental behavior through interview employing a life grid. The early life socioeconomic conditions measure was determined by occupation of the head of household in childhood. Adult socioeconomic measures included participant's education and current occupation of the head of household. Marginal structural models with stabilized inverse probability weights were used to estimate the controlled direct effects of early life socioeconomic conditions on oral cancer. Results: The total effect model showed that those in the low socioeconomic conditions in the early years of childhood had 60% (risk ratio [RR] = 1.6 [95% confidence interval {CI} = 1.4, 1.9]) increased risk of oral cancer. From the marginal structural models, the estimated risk for developing oral cancer among those in low early life socioeconomic conditions was 50% (RR = 1.5 [95% CI = 1.4, 1.5]), 20% (RR = 1.2 [95% CI = 0.9, 1.7]), and 90% (RR = 1.9 [95% CI = 1.7, 2.2]) greater than those in the high socioeconomic conditions when controlled for smoking, chewing, and alcohol, respectively. When all the three mediators were controlled in a marginal structural model, the RR was 1.3 (95% CI = 1.0, 1.6). Conclusion: Early life low socioeconomic condition had a controlled direct effect on oral cancer when smoking, chewing tobacco, and alcohol were separately adjusted in marginal structural models. Refereed/Peer-reviewed

Nutritional status affects outcome in acute illnesses. Weight loss is associated with poor lung functions and outcome in chronic obstructive pulmonary diseases (COPD). There is not much data on the effects of nutritional status on hospital outcome in patients with acute exacerbation of COPD. This study was conducted to address this issue. Twenty five patients with COPD admitted with acute exacerbation in a tertiary care teaching hospital in Southern India were studied. Lung functions were as-sessed by spirometry. Nutritional status was assessed using anthropometric mea-sures {body mass index (BMI), mid-arm circumference (MAC), triceps skin-fold thickness (TSF) and fat free mass (FFM)}. Resting energy expenditure (REE) was measured using indirect calorimetry. Hospital outcome was determined by mortal-ity, number of days to improve subjectively and number of days to discharge. Patients with a lower BMI, MAC and TSF took a longer time to recover. REE was found to be lower in patients with weight loss unlike the Western patients. On multivariate analysis, only a lower BMI was associated with a longer time to re-covery. Thus, nutritional status is an important predictor of hospital outcome in patients with COPD.

Stromal tumours occurring in areas other than the GastroIntestinal Tract (GIT) are known as Extra GastroIntestinal Stromal Tumours (EGISTs). They usually arise in the mesentery, omentum or retroperitoneum, while EGISTs which occur in the abdominal wall are very rare. Both gastrointestinal stromal tumours (GISTs) and EGISTs are histologically and immunophenotypically similar. We are reporting a case of EGIST, which occurred in the anterior abdominal wall in a twenty five-year-old female patient. The tumour was present in the right loin and imaging studies suggested that it was a desmoid tumour. It was surgically excised by doing an abdominal wall mesh repair. The histological examinations revealed a tumour with spindle cell morphology, with

BACKGROUND: Vision loss and age-related eye diseases are major global public health problems. The burden of visual impairment worldwide varies depending on the methods of assessment. The need for local data on the prevalence of visual impairment in adults coupled with limited resources necessitated the conduct of the study in a limited geographical area. METHODS: A cross-sectional study was conducted in the field practice area of Department of Community Medicine of a Medical College. Study patients included adults aged ≥18 years, identified through purposive sampling. A semi-structured questionnaire was used to collect sociodemographic data. Snellen's chart for distant vision; reduced Snellen's chart for near vision and Ishihara chart for color vision was used. Data were analyzed using SPSS software version 15. RESULTS: The study included 411 patients. Nearly 40% of the patients were ≥50 years. Among the patients, 195 (47.4%) had H/o refractive error, 78 (19%) had H/o hypertension, 56 (13.6%) had H/o diabetes, and 43 (10.5%) had H/o cataract. The most common ocular morbidity was arcus senilis 113 (27.5%) and cataract 28 (6.8%). Using Snellen's distant vision chart low vision ( CONCLUSIONS: Farsightedness was detected among a quarter of the population, while impaired near vision was detected among two.fifths of the study group. Nearly 7% of patients had cataract and were referred for further evaluation. Advancing age and the presence of comorbidities were significant determinants of visual impairment.

Currently, the nursing profession lacks specialized training, to be a part of preventive cardiovascular healthcare team. The article aims to describe the obstacles Indian nurses face in becoming active and valued members of the cardiovascular healthcare team and to propose solutions. Cardiovascular disease (CVD) imposes substantial and increasing physical, psychological, societal, and financial burdens. More emphasis needs to be placed on preventive measures, which should be made available and affordable in rural as well as urban areas. Nurses are well positioned to be leaders in these initiatives. However, nurses in India face numerous obstacles in providing optimal care, including a significant shortage of trained personnel. Nursing education at advanced levels needs to be standardized and should reflect core competencies. Appropriate use of nursing resources in CVD prevention can allow physicians to treat the sickest patients, reduce cost of care, and help relieve the human burden of morbidity and mortality due to CVD.

Background: Pelvic floor dysfunction predominantly affects women of all the ages with an increasing prevalence with advancing age. Very few studies on prevalence of urinary incontinence have been conducted in India and none in Udupi taluk. Aim: The aim of this cross-sectional study is to estimate the prevalence of Pelvic Floor Dysfunction among married women of Udupi taluk, Karnataka, India and to evaluate the impact of age, educational qualification, occupation, parity and mode of delivery on pelvic floor dysfunction. Materials and Methods: A cross-sectional study was conducted on 1256 married women using a structured questionnaire. Women were interviewed at their residence using the questionnaire. Institutional ethical committee approval and written informed consent was obtained before the interview. Result: Prevalence of pelvic floor dysfunction was reported to be 21% with 19.02% of the women experiencing urinary incontinence and 1.99% experiencing pelvic organ prolapse. The mean age of the women participated in this study was 45.4 ± 11.8 (ranging between 18-70 years). Eighty seven percent of the women were housewives and 69% of the women had only primary education. Statistically significant association was found between age (p ≤ 0.001), occupation of the women (p ≤ 0.001), presence of urinary incontinence during pregnancy which disappeared after delivery (p=0.009) and occurrence of at least one type of pelvic floor dysfunction. Age, occupation and presence of symptom of urinary incontinence during pregnancy which disappeared after the delivery were reported as the independent predictor of symptoms of pelvic floor dysfunction when analyzed with multivariate logistic regression model. Conclusion: Prevalence of pelvic floor dysfunction among women of Udupi Taluk, Karnataka, India was found to be 21% with age, occupation and presence of symptom of urinary incontinence during pregnancy which disappeared after the delivery as the independent predictor of symptoms of pelvic floor dysfunction.

BACKGROUND The mean lysine requirement of healthy Indian subjects was estimated from short-term experimental diet periods to be 29 mg x kg(-1) x d(-1), which is higher than the 1985 FAO/WHO/UNU upper requirement of 12 mg x kg(-1) x d(-1). OBJECTIVE Our objective was to confirm our proposed requirement of 29 mg x kg(-1) x d(-1) by extending the diet period to 21 d and by using 4 test lysine intakes (12, 20, 28, and 36 mg x kg(-1) x d(-1)) and a 24-h indicator amino acid oxidation and balance approach. DESIGN During two 21-d diet periods, 18 healthy Indian men were randomly assigned to receive 12 and 28 or 20 and 36 mg lysine x kg(-1) x d(-1) as part of an L-amino acid diet. At 1800 on days 6 and 20, [(13)C]leucine was infused over 24 h to assess leucine oxidation and daily leucine balance at each test intake. RESULTS Leucine oxidation, balance, and flux did not differ significantly between days 7 and 21. Twenty-four-hour leucine oxidation was lower at lysine intakes of 28 and 36 mg than at 12 and 20 mg. Leucine balances at lysine intakes of 12 and 20 mg were negative and significantly less than equilibrium (P < 0.01) and lower (P < 0.02) than balances at 28 and 36 mg lysine. Two-phase regression analysis indicated a breakpoint at 31 mg lysine x kg(-1) x d(-1) in the relation between lysine intake and 24-h leucine oxidation and balance. CONCLUSIONS Full adaptation to a low lysine intake occurs within 7 d. The previously proposed tentative mean lysine requirement for Western subjects of 30 mg x kg(-1) x d(-1) is confirmed for healthy Indian adults.

Apoptotic mechanisms are centre stage for the development of injury in the immature brain, and caspases have been shown to play a pivotal role during brain development and in response to injury. The inhibition of caspases using broad-spectrum agents such as Q-VD-OPh is neuroprotective in the immature brain. Caspase-6, an effector caspase, has been widely researched in neurodevelopmental disorders and found to be important following adult stroke, but its function in the neonatal brain has yet to be detailed. Furthermore, caspases may be important in microglial activation; microglia are required for optimal brain development and following injury, and their close involvement during neuronal cell death suggests that apoptotic cues such as caspase activation may be important in microglial activation. Therefore, in this study we aimed to investigate the possible apoptotic and non-apoptotic functions caspase-6 may have in the immature brain in response to hypoxia-ischaemia. We examined whether caspases are involved in microglial activation. We assessed cleaved caspase-6 expression following hypoxia-ischaemia and conducted primary microglial cultures to assess whether the broad-spectrum inhibitor Q-VD-OPh or caspase-6 gene deletion affected lipopolysaccharide (LPS)-mediated microglial activation and phenotype. We observed cleaved caspase-6 expression to be low but present in the cell body and cell processes in both a human case of white matter injury and 72 h following hypoxia-ischaemia in the rat. Gene deletion of caspase-6 did not affect the outcome of brain injury following mild (50 min) or severe (60 min) hypoxia-ischaemia. Interestingly, we did note that cleaved caspase-6 was co-localised with microglia that were not of apoptotic morphology. We observed that mRNA of a number of caspases was modulated by low-dose LPS stimulation of primary microglia. Q-VD-OPh treatment and caspase-6 gene deletion did not affect microglial activation but modified slightly the M2b phenotype response by changing the time course of SOCS3 expression after LPS administration. Our results suggest that the impact of active caspase-6 in the developing brain is subtle, and we believe there are predominantly other caspases (caspase-2, −3, −8, −9) that are essential for the cell death processes in the immature brain.

BackgroundRotavirus is the leading cause of severe, dehydrating diarrhea in children aged

This report presents nationally representative estimates and trends for human immunodeficiency virus (HIV) testing among the U.S. household population aged 15-44. Data are presented for lifetime experience with HIV testing and HIV testing in the past year, including testing done as part of prenatal care.Data for this report come from the 2006-2010 National Survey of Family Growth (NSFG), consisting of 22,682 interviews with men and women aged 15-44, conducted from June 2006 through June 2010. The overall response rate for the 2006-2010 NSFG was 77%: 78% for women and 75% for men.Among U.S. women aged 15-44, the percentage ever tested for HIV outside of blood donation increased significantly from 35% in 1995 to 55% in 2002, and to 59% in 2006-2010. Among men aged 15-44, the percentage ever tested outside blood donation fell from 47% in 2002 to 42% in 2006-2010. Within gender groups in 2006-2010, the proportions ever tested for HIV outside of blood donation were similar for Hispanic and non-Hispanic white persons: roughly 6 out of 10 among women and 4 out of 10 among men. However, a higher percentage of non-Hispanic black women (75%) and non-Hispanic black men (61%) had ever been tested for HIV outside of blood donation. Based on 2006-2010 data, 21% of women were tested for HIV within the 12 months prior to interview, compared with 13% of men. While NSFG data cannot ascertain the temporal sequencing of risk-related behaviors and HIV testing, the data indicate that testing within the past year occurs more often among individuals reporting potential HIV risk-related behaviors.

BACKGROUND: The understanding of HIV/AIDS by MBBS students and their attitudes towards managing a retropositive patient will impact their practice in future. OBJECTIVES: To study the knowledge and attitude about HIV/AIDS among medical students and to analyse change in knowledge levels based on year of study of MBBS. METHODOLOGY: A cross-sectional questionnaire based study was conducted in a private medical college in Karnataka among 610 MBBS students. Aspects regarding general and clinical knowledge of HIV/AIDS, attitude towards HIV infected patients were dealt with. RESULTS: An increasing trend in the knowledge from 1st to 4th year was seen in the following aspects: knowledge regarding vertical transmission (78% to 93.3%), transmission through breast feeding (31.9% to 85.3%), tuberculosis as the most common opportunistic infection in HIV/AIDS (26.9% to 70%), correct time of initiation of post exposure prophylaxis (5% to 46.7%), facility for getting HIV test done confidentially (0.6% to 42.7%). An increasing trend in the negative attitude towards HIV patients was seen from 1st to 4th year when it came to right to refuse surgical treatment to HIV patient (40% to 56%) and an increasing trend in the favourable response towards HIV patients were seen from 1st year to 4th year when it came to their opinion whether HIV patients can be kept in general ward (57.5% to 78%). CONCLUSION: From the above study we conclude that the knowledge level on HIV/AIDS improved based on year of study. Discriminatory attitude towards HIV patients still persisted among students of all the years.